Measles information and advice from the Canterbury DHB

Measles is now in widespread circulation. People who aren't fully immune could be exposed to the risk of infection anywhere in Canterbury.

There has been two confirmed cases in, firstly a staff member, then a student, at the University of Otago, Christchurch. We have comprehensive contact lists for these two people and have issued them with the Canterbury DHB's information for those known to have been in close contact with confirmed cases. Those close contacts who are not immune have gone into isolation.

The Canterbury DHB advises that only those who have been in known contact with a confirmed case should stay away from their work, or go into isolation, if they are not fully immune. If you are immune you cannot carry the virus and pass it on to others. If you were born between 1969 and 1992 and have had only one measles (MMR) vaccination, you will need a second 'booster' to be fully immunised. The Canterbury DHB advises those needing vaccination, or who want to query their immunisation status, should do so through their GP.

Latest information on measles in Canterbury

Only people who were born before 1969 or have had two MMR vaccinations are considered fully protected. Those aged between 29 and 50 will only have had one measles vaccination and are not considered immune.

Extra supplies of the MMR vaccine in Canterbury are being delivered, with 18,000 doses expected to be available in practices from Wednesday. General practice teams have been asked to prioritise the following groups for MMR immunisation, in this order:

1. People who are not up-to-date according to the schedule for their age group
   • Children and young adults (age range 5 years to 28 years) who are either not immunised or who have only received one MMR dose to date.
   • Children 12 months to 5 years who have never received any doses of MMR.
2. The four-year-old MMR can be brought forward to no sooner than four weeks after the previous MMR.
3. Adults aged 29 to 50 (this group only received one dose of measles vaccine).

Measles fact sheet

• Measles is a highly infectious viral illness spread by contact with respiratory secretions through coughing and sneezing
• Symptoms of measles include:
  • A respiratory type of illness with dry cough, runny nose, headache
  • Temperature over 38.5 C and feeling very unwell
  • A red blotchy rash starts on day 4-5 of the illness usually on the face and moves to the chest and arms.
• People are infectious from five days before the onset of the rash to five days after the rash starts.
• Infected persons should stay in isolation – staying home from school or work - during this time.
• The best protection from measles is to have two MMR vaccinations. MMR is available from your general practice and is free to eligible persons.
• People are considered immune if they have received two doses of MMR vaccine, have had a measles illness previously, or were born before 1969.
• Anyone believing they have been exposed to measles or exhibiting symptoms, should not go to the ED or after hours' clinic or general practitioner. Instead call your GP any time, 24/7 for free health advice.

For more information about measles refer to the Ministry of Health website or The Immunisation Advisory Centre's website.

Sunday 10 March 2019

Measles is circulating widely in Canterbury. There has been a confirmed case in someone working at the University of Otago, Christchurch. The following is information and advice for staff and students.

If you have a question not covered in this information, contact kim.thomas@otago.ac.nz or vicky.cameron@otago.ac.nz who will seek answers for you.

What is measles?

• Measles is a serious and highly infectious viral disease that can make people very sick and can lead to hospitalisation or, in rare cases, death.
• It is spread from person-to-person through the air by breathing, sneezing or coughing. Just being in the same room as someone with measles can lead to infection if you are not immunised.
• Unimmunised people who come within 2 metres of an infectious person, however briefly, have a 90% chance of contracting measles.
• One person can pass the disease to 13 other people who have not been immunised.
• Early symptoms include fever, cough, runny nose, sore eyes and white spots inside the mouth. After three to five days a rash appears on the face and then moves down the body.
• Up to one in three people with measles develops complications, including ear infections, pneumonia or diarrhoea. Acute encephalitis (brain inflammation) develops in one in 1,000 cases, some of whom die and more than one third are left with permanent brain damage. Pregnant women who get measles are at risk of miscarriage, stillbirth and having a low birth weight baby.
• One in 1000 people with measles may die and one in 10 cases will end up in hospital.
• The best protection against measles is immunisation with a vaccine called MMR (Measles, Mumps and Rubella).

Who is at risk of getting measles?

• Anyone born after 1 January 1969, who hasn't had two doses of measles vaccine after their first birthday, or has not had a documented case of measles already, is at risk of catching the disease because they are not likely to be immune.
• Anyone with a weakened immune system (for example, people who are receiving chemotherapy or radiotherapy for cancer, or people who take high-dose steroid medications) is at risk of measles infection even if they have had measles in the past or been immunised.
• When measles is widespread a very small proportion of people who have been immunised may also get measles.

What to do if you think you have been in 'contact' with measles

• 'Contacts' are people who shared the same air with someone while they are infectious with measles (for example being in the same room)
• Contacts who are not immune to measles may become infected and spread it to other people even before they start to feel very sick. It takes 7 -14 days for an infected contact to start to have symptoms.
• People who contract measles are infectious from five days before the onset of the rash and should stay in isolation as soon as they suspect they may be infected until five days after the rash first appears. People who experience symptoms - fever, cough, runny nose, sore eyes, white spots inside the mouth, or a rash - should stay home from work and have no contact with unimmunised people. If others in the household are unimmunised, they need to stay in isolation too for at least 14 days from likely first exposure and seek further advice before ending their period of isolation. Isolation (quarantine) means staying at home and away from work, group and social activities, sports and recreation events and public places like cinemas and shopping malls.
• If you have been in contact with measles but you are immune (see 'What is Measles?' section above to determine your likely immunity) you don't need to do anything.
• If you are a 'high-risk contact' – this includes non-immune pregnant women and people with a weak immune system (from illness or medicine), you should contact your doctor, maternity carer or specialists as soon as possible for advice.
• If you are unsure of your measles immunity you should speak to your doctor who will advise whether you require MMR vaccinations.

What if I become unwell?

• 'Look out for signs and symptoms of measles including a runny nose, cough, sore eyes, fever, a raised red rash that starts on the face and moves to cover the rest of the body.
• If you think you are developing signs of measles while you are in isolation you should call your family doctor for advice.
• There is no specific treatment for measles. Supportive treatment includes rest,plenty of fluids, and paracetamol for fever.
• If you become increasingly unwell with measles and need to see a doctor. Phone the medical centre or hospital before you go so they can isolate you to prevent the spread of measles in their clinic.
• If you are diagnosed with measles while you are in isolation, you need to stay in isolation until five days after the measles rash starts. For example, if you develop a rash on 15 October, you cannot leave isolation until 20 October.
• Even if you did get measles it's worth having the MMR immunisation onceyou have recovered, as it also protects against rubella and mumps.

What if I go into isolation but do not become unwell?

• If you don't get measles you can come out of isolation after 14 days from your last exposure to someone with measles.
• If you have not had two MMR vaccinations you should arrange with your GP to be immunised. Immunisation with MMR is free for anyone born after 1January 1969.

The best way to avoid catching measles is getting immunised. If you suspect youare sick with measles, phone your GP or Healthline on 0800 611 116. For more information on immunisation, please call the Immunisation Advisory Centre free on 0800 IMMUNE (0800 466 863) or visit their website www.immune.org.nz