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Measles

Notifying suspected measles to Toi Te Ora Public Health / Medical Officer of Health

If you suspect a case of measles, please notify the Medical Officer of Health promptly on 07 579 8000 (ask for the Medical Officer of Heath). Alternatively, you can phone 0800 221 555 to speak to other communicable disease staff (select option 3 during business hours, or option 5 after hours).

Do not wait for laboratory results before notifying.

Our current rates of immunisation coverage are below the 95% required to prevent the spread of measles, so urgent public health follow up of suspected or confirmed cases is important.

Toi Te Ora Public Health occasionally arranges IgG testing if an individual is a contact of a case of measles and is unable to confirm their vaccination status. Such a person will be put into quarantine. However, they may be offered IgG testing, as if they return a positive IgG result they can be released from quarantine.

More specific advice about measles serology testing for diagnostic purposes is available on the Pathlab website.

National
ESR produces measles reports which include information on the epidemiology of measles cases reported in New Zealand. Measles is a notifiable disease in New Zealand and these reports use data available from EpiSurv, the national notifiable disease database.

International
Measles outbreak regions around the world can be viewed here.

Key points:

Measles occurs in all ages.
The characteristic maculo-papular rash follows first prodromal symptoms by 2-3 days.
Patients are infectious 5 days before the onset of the rash until 5 days after onset of the rash.
Measles is highly contagious, spreading via the air or surface droplets.
A single case is defined as an outbreak requiring urgent public health intervention – therefore urgent lab testing for confirmation of a suspected case is critical.

Clinical events

Infectivity

Contact

10-12 days Incubation period
(can be up to 21 days)

Prodrome

2-4 days fever, runny nose, cough, conjunctivitis, koplik's spots

Rash
Up to 1 week spreading maculo-papular rash
(ongoing fever and symptoms as above but
most unwell first 2 days of rash)

From:
Prodrome onset
(i.e up to 5 days before onset of rash)

Until:
5 days after onset of rash.

Apart from the clinical picture, other factors which should raise clinical suspicion include:

Possible Contact / Exposure with known or possible case eg: school, pre-school, playmates, friends, relatives with above symptoms.
Increased Community Risk – if individuals were born between 1969 and 1975, they may not have a good measles immunity.
Susceptible Individuals – those who do not have documented immunity to measles or who have not received two doses of MMR vaccine or, for those aged < 4 yrs, have not received one dose after 12 months of age.
Immunocompromised Individuals – should be considered for immunoglobulin.

Measles - GP Flow Chart - Toi Te Ora Public Health summary and advice on local guidelines for diagnosis and management.
Infectious Disease Notification Form

On-call Medical Officer of Health - 07 579 8000 (Tauranga Hospital)

Think Measles - a resource for the public which can be printed as a poster and displayed, for example, in clinic waiting rooms
Attention: You could have measles – an alert poster that can be displayed at clinic entrances and reception desks
Guardians of the future - resources from the Health Promotion Agency.

Websites with measles information

Updated 31 May, 2021

Measles

Notifying suspected measles to Toi Te Ora Public Health / Medical Officer of Health

IgG testing

Measles case numbers - national and international

Measles overview

Clinical documents

Resources