Overnight, New South Wales announced another two cases of measles bringing its total “since Christmas” to 30 cases.[1] Today Queensland announced another two as well. But perhaps more worrying is the very sudden but much quieter measles outbreak happening in the Northern Territory (NT).[10] Measles hot spots are popping up all over Australia.
Photo by Joey Csunyo on Unsplash
In 2014, Australia was officially certified by the World Health Organization (WHO) as having eliminated measles.[10,2] Measles is a vaccine-preventable disease, and Australia has good vaccine uptake. In a country free of transmission, any case is considered an outbreak. Generally speaking, twice the normal 7-18 day incubation period must pass before an outbreak ends.[17,18]
Source: CDC PHIL. [16]
The cases Australia detects begin when an infected visitor or citizen returning from travel to countries without sufficient vaccine coverage. Sometimes, those cases pass the infection to others within Australia who are not adequately immunised. This transmission is especially obvious when it occurs in a pocket of unvaccinated people. Our high vaccine coverage means this doesn’t happen very often. But 2019 is
2019 is seeing quite a few new measles cases
Measles hot spots have popped up all over Australia. Victoria is up to 9 cases for 2019 [2], South Australia has had 2 [4], Western Australia reports 15 [5], 1 has been reported from the Australian Capital Territory, Queensland has reported 9-11 [7-9] and Tasmania remains measles-free in 2019. Darwin in Australia’s Northern Territory recently reported 23 cases.[11] These aren’t all worryingly unusual numbers overall, but some are, and some are high for this early in the year.
Data from the
NATIONAL NOTIFIABLE DISEASES SURVEILLANCE SYSTEM
Is the Darwin outbreak still going?
The Northern Territory produced a series of media releases from early March, detailing a rapid rise in new Measles cases.
The first case was
The March 26th update listed 12 cases, all from around the local area.[14] The last update, March 28, described 23 cases and noted that initial measles-mumps-rubella vaccinations would now include 9-12-month-old babies, thus dropping the age at which the first of two vaccine doses are given by three months.[10] This final update noted that most cases so far were in adults. There were “well over” 1,000 contacts of cases.
But that last report was over a week ago. Given how steep the curve (above) was up until the 28th, it’s very tempting to think that there have been more cases since then. But the national figures also haven’t moved so perhaps the outbreak was very
It is important to find out what’s happening in the NT. Messaging helps remind the local population about vaccination and boosters. Communication also alerts the rest of the country to the degree of risk to expect from travelling to, and in travellers from, the Darwin area.
Source: CDC PHIL. [15]
There are a lot of causes of fever and rash. Sometimes it’s hard to narrow down a likely culprit in the early stages of a disease. Travel and contact history help inform initial laboratory testing and management of patients. Knowing that travel from within Australia could be a factor – not just from a known overseas measles hot spot – is important information to have.
Stay tuned.
References
- Fresh alert as measles cases hit 30
https://www.health.nsw.gov.au/news/Pages/20190404_00.aspx - Elimination of endemic measles transmission in Australia
https://www.who.int/bulletin/volumes/87/1/07-046375.pdf - Vaccine preventable diseases summary | Victoria State Government
https://www2.health.vic.gov.au/public-health/infectious-diseases/infectious-diseases-surveillance/search-infectious-diseases-data/vaccine-preventable-diseases-summary - Measles case in Adelaide
https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/protecting+public+health/alerts/health+alerts/measles+case+in+adelaide - Measles Notifications | Department of Health, WA Government
https://ww2.health.wa.gov.au/Articles/N_R/Notifiable-infectious-disease-report?report=measles - Health alert: Measles case notified in Canberra
https://www.health.act.gov.au/public-health-alert/health-alert-measles-case-notified-canberra - Notifiable conditions reports: Summary information | Queensland Govt, Queensland Health
https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/surveillance/reports/notifiable/summary - National Notifiable Diseases Surveillance System (NNDSS) | Commonwealth of Australia
http://www9.health.gov.au/cda/source/rpt_4.cfm - Health authorities warn of a measles outbreak in Queensland’s north
https://www.couriermail.com.au/news/queensland/health-authorities-warn-of-a-measles-outbreak-in-queenslands-north/news-story/31cbe8e761024a00b6393d036b528e9d - Third Annual Meeting of the Regional Verification Commission for Measles Elimination in the Western Pacific | WHO WPRO
https://apps.who.int/iris/bitstream/handle/10665/208616/RS_2014_GE_04_KOR_eng.pdf - Measles Update – Vaccination program extended
https://health.nt.gov.au/news/measles-update-vaccination-program-extended - Measles alert
https://health.nt.gov.au/news/measles-alert - Further measles cases in Darwin
https://health.nt.gov.au/news/further-measles-cases-in-darwin - Update – Measles outbreak
https://health.nt.gov.au/news/update-measles-outbreak - Measles, CDC Public Health Image Library
https://phil.cdc.gov/details.aspx?pid=3168 - Measles virus
https://phil.cdc.gov/details.aspx?pid=8429 - Manual for the Surveillance of Vaccine-Preventable Diseases
Chapter 7: Measles
https://www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html - Measles | National guidelines for public health units
http://www.health.gov.au/internet/main/publishing.nsf/Content/cdna-song-measles.htm