Measles: A global issue

Measles: A global issue

Despite New Zealand’s best efforts to immunise against Measles, our country will always be at risk while the virus circulates and spreads through other parts of the world.

Measles has no respect for borders; it’s highly infectious nature causes it to whip from person to person, city to city and often country to country. This year alone many outbreaks have been confirmed, the latest affecting more than 1000 people in the town of Dortmund, Germany, a venue for one of the Soccer World Cup matches.
America’s Centre for Disease Control has issued a warning to the public and doctors in the US to be vigilant for signs of measles in travellers returning from Germany, given the likelihood of exposure during an event which is expected to draw more than one million tourists who will be in close proximity.
The risk is just as real for other countries too, if the virus is unwittingly spread from country to country.

A recent example of the global spread of measles comes from Spain. Investigations show a measles outbreak started with two cousins who had travelled from the UK in January - both were unimmunised. Despite one boy being admitted to hospital, no one realised he had measles until his cousin became ill two weeks later.

By that time the virus had spread far and wide. By March 57 additional cases had been diagnosed around Madrid, 9 being health care staff. Furthermore, a later outbreak in Venezuela in May appears to have started with an airline pilot who picked up measles when he was in Madrid in February.
A separate outbreak occurred in Denmark with a man who had no known exposure to measles and had not travelled recently. A number of others were infected however what makes this outbreak interesting is the fact that the type of measles virus identified in this outbreak was genotype B3. This genotype commonly circulates in Central and Western Africa – a long way from Denmark.
In Sweden, a woman travelling through Europe via Copenhagen airport became ill, on the same day as the first patient in Denmark. Eight people became ill with measles as a result of contact with the woman, including a couple who had travelled to Thailand and India via Copenhagen airport. None of the infected people in Sweden or Denmark had been vaccinated.
These outbreaks show the rampant nature of how measles spreads and gives us a pertinent reminder about the highly infectious nature of the virus.
Following recent outbreaks in Fiji, Australia and Germany, the Ministry of Health issued an alert for travellers to check their measles mumps and rubella (MMR) vaccinations are up-to-date.

Children under five should receive the vaccine at fifteen months and four years of age. The vaccine is available free, although those born before 1969 are likely to be immune from having caught measles in childhood.

Some people born between 1969 and 1975 may still be vulnerable to measles as they only had one, early dose of the vaccine.

IMAC urges people to get up to date with MMR vaccine

The Immunisation Advisory Centre (IMAC) is concerned that outbreaks of measles overseas could threaten unvaccinated New Zealanders.

IMAC Director Dr Nikki Turner stresses that while there is currently no outbreak of measles in New Zealand, the dangerous disease is only a plane-ride away. “Kiwis are great travellers and we are concerned that people who are exposed to measles overseas can potentially bring it back to New Zealand”.

What is measles?

Measles is a highly infectious virus that can cause serious complications like pneumonia and encephalitis (swelling of the brain). The initial symptoms of measles are fever, eye irritation, coughing and small white spots in the mouth. These symptoms quickly turn into a bad rash that can spread over the entire body.

What is the MMR vaccine?

“Most New Zealand children are vaccinated for measles, mumps and rubella with the MMR vaccine, which is received at fifteen months and four years of age. If a child has not received the vaccine or has only received one dose, the child is potentially at risk” says Dr Turner.

When was the last measles epidemic in NZ?

The last measles epidemic swept through parts of New Zealand in 1997. Over 2000 cases were reported and more than 300 people were so ill with complications of the disease, they needed to be hospitalised. Measles complications such as encephalitis also caused 7 deaths in the 1991 epidemic.

A study in 2005 predicted that New Zealand may not get another measles epidemic for 10-20 years and that interval could be longer if immunisation coverage rates improve. Although a few cases of measles are reported in New Zealand each year, the main risk is from imported cases or international travel.

Advice

Unvaccinated people planning to travel overseas should ask their GP or travel medicine specialist about the need for the MMR vaccine.

IMAC also asks parents to ensure children receive MMR along with the other scheduled childhood vaccinations and be vigilant for signs of the disease if a child has not yet had two doses.

The MMR vaccine should be given to anyone who is known to be susceptible to one or more of the three diseases.

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