The Department of Health and Human Services continues to be notified of confirmed cases of measles in people residing in Melbourne. The majority of cases have been in un- or under-vaccinated younger adults.

Last month we shared the news of a measles outbreak in Melboure, there has now been twenty-one people confirmed to have contracted measles.

Dr Roscoe Taylor, Acting Chief Health Officer, Victoria is urging people ongoing clinical vigilance is required across Greater Melbourne.

The outbreak began in February in Brunswick and surrounding areas. But cases are now occurring in other suburbs. Most cases of measles in Victoria in recent years originate from returned travellers who have visited a measles-affected country. Whether this has been the situation with the current outbreak is unclear.

The measles outbreak has also spread to two primary schools in Melbourne – Princes Hill Primary School in North Carlton and Footscray West Primary School in Melbourne’s inner west are alerting parents to cases of the illness. Education Minister James Merlino said students and teachers at Princess Hill Primary who can’t prove they are fully immunised against the viral infection will have to do their school work from home.

A warning letter was also sent to all students and staff at Swinburne University advising them of confirmed cases from the Hawthorn campus.

‘Measles have been diagnosed in individuals living in Brunswick and surrounding suburbs during February and March,’ Victorian Chief Health Officer Roscoe Taylor said in a statement on Thursday.

The contagious viral illness is infectious through airborne transmission but can be controlled through vaccinations.

Symptoms include fever, runny nose, red eyes and a cough followed by a rash.

Who is at risk?

•Children or adults born during or since 1966 who do not have documented evidence of receiving two doses of a measles-containing vaccine, or documented evidence of laboratory-confirmed measles immunity are considered to be susceptible to measles.

•People who are immunocompromised are also at risk.

Symptoms and transmission

Measles initially presents with a prodrome of fever, cough, conjunctivitis, and coryza. A generalised maculopapular rash develops two to five days after the onset of the prodrome, coinciding with fever. Koplik spots on the buccal mucosa may be present for three to four days prior to rash onset but not at time of rash. Individuals, especially children, are typically unwell.

Clinical case definition: the following clinical features must be present to meet the case definition for measles:

• generalised maculopapular rash, usually lasting three or more days, AND

• fever (at least 38°C, if measured) present at the time of rash onset, AND

• cough or coryza or conjunctivitis.

Measles is transmitted by airborne droplets and direct contact with discharges from respiratory mucous membranes of infected persons and less commonly by articles freshly soiled with nose and throat secretions.

Measles is highly infectious and can persist in the environment for at least 30 minutes.

The incubation period is variable and averages 10 days (range: 7 – 18 days) from exposure to the onset of fever, with an average of 14 days from exposure to the onset of rash.

The infectious period of patients with measles is five days before, to four days after, the appearance of the rash.

People with immediate concerns can check the FAQ sheet on health.vic

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