Measles case in Adelaide metropolitan area

24 January 2012

The Communicable Disease Control Branch (CDCB) has been notified of a case of measles in an unvaccinated man from metropolitan Adelaide. The infection was acquired overseas. Please be aware that secondary cases may begin to present from now onwards.

During the infectious period the case visited the following sites, and people visiting these sites during the hours indicated may have been exposed:

• Saturday 14 January: Hyde Park Tavern, 187 King William Road, Hyde Park, 1700 to 2000 hours.
• Monday 15 and Tuesday the 16 January: Euro Explorations Services, 63 King William Street, Kent Town, 0900 to 1900 hours.
• Tuesday 17 January: Hughes Clinic, 160 Unley Road, Unley, 1630 to 1930 hours.
• Tuesday 17 January: Haddad Pharmacy, 160 Unley Road, Unley, 1700 to 1930 hours.
• Thursday 19 January: Foot and Ankle Centre, 22 Walter Street, North Adelaide, 1130 to 1430 hours.
• Thursday 19 January: Jones and Partners Radiology on Level 1, St Andrews Hospital, 1300 to 1630 hours.
• Thursday 19 January: Hughes Clinic, 160 Unley Road, Unley, 1630 to 1930 hours.
• Saturday 21 January: Hughes Clinic, 160 Unley Road, Unley, 1000 to 1230 hours.
• Saturday 21 January: Haddad Pharmacy, 160 Unley Road, Unley, 1030 to 1300 hours.
• Sunday 22 January: Royal Adelaide Hospital Emergency Department, 1700 to 1900 hours.

Incubation period and symptoms

Measles is highly contagious viral infection transmitted via respiratory aerosols which remain a risk to others for up to two hours after the infectious person has left the area. The incubation period is about 10 days (range seven to 18 days) to the onset of prodromal symptoms and about 14 days to the appearance of the rash. The illness is characterised by cough, coryza, conjunctivitis, a descending morbilliform rash, and fever present at the time of rash onset. The infectious period is from five days before the appearance of the rash to four days after the appearance of the rash.

What to do for all suspected cases of measles

• Arrange urgent laboratory testing through SA Pathology, including measles IgM and IgG (specify both) (clotted serum tube, white top), a throat or conjunctival swab in viral transport medium, and urine in yellow top container if possible.
• Isolate suspected and confirmed measles cases and exclude from childcare/ school/ workplace until at least four days after the appearance of the rash.
• Ensure that all household contacts are protected against measles as indicated in the Australian Immunisation Handbook 9th ed. pp 209 to 211.
• Doctors are asked to urgently notify any patient suspected to have measles to the CDCB on 1300 232 272 (24 hours, 7 days). Do not wait for laboratory confirmation.

How to minimise transmission in the surgery

• Examine patients suspected of having measles in their own homes whenever possible
• For suspected cases, avoid using the waiting room and conduct consultation in a room that can be left vacant for at least two hours afterwards
• Treat all people who attend the rooms within two hours of the (confirmed) infectious patient as contacts as indicated in the Australian Immunisation Handbook 9th ed. pp 209 to 211.
• Maintain surveillance for more cases in your practice

Review the vaccination status of all persons during or after 1966 who attend your practice for any reason, and offer MMR vaccination to all susceptible people (those who have no vaccination or only 1 dose).

For all enquiries please contact the CDCB on 1300 232 272 (24 hours, 7 days)

Dr Ann Koehler - Director, Communicable Disease Control Branch