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Measles GP Information

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Link to ESR Fortnightly Measles report

The ESR measles report is updated fortnightly and available here.

Key documents

GP Measles Flowchart

Case notification

Please notify any suspected measles cases immediately to the Medical Officer of Health and dicuss the process for laboratory confirmation of the diagnosis without delay.

Phone 0800 221 555, select option 6 (during business hours)
Complete the Infectious Disease Notification Form and fax to 0800 66 89 34
Email toiteorasupport@bopdhb.govt.nz
Urgent/after hours 0800 221 555, select option 7
On-call Medical Officer of Health 07 579 8000 (Tauranga Hospital)

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

Ministry of Health measles information:

MOH measles webpage

IMAC
Measles resource for health professionals

Measles overview

Key points:

Measles occurs in all ages.
The characteristic maculo-papular rash follows first prodromal symptoms by 2-3 days.
Patients are infectious 3-4 days before the onset of the rash until 4 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 4 days before onset of rash)

Until:
4 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 (now 34 - 40 years)
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.

Useful websites

Immunisation Advisory Centre website
Specimen Collection and Transport

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