Stakeholders Update on the Auckland Measles Outbreak

13th July 2011

Stakeholders Update on the Auckland Measles Outbreak

Kia Ora Tatou Tena Koutou Katoa and Warm Pacific Greetings.

The Auckland region is now in its second and largest measles outbreak for 2011. It began in mid-May and, two months later, the number of people infected with measles continues to rise. Measles is a serious and highly infectious disease that can make people very sick. One third of cases experience serious complications and in rare cases, death. Immunisation is the only way to prevent measles.

Outbreak Status

As at 9am, the Auckland Regional Public Health Service has now confirmed:

• 64 confirmed cases of measles in the Auckland region
• 8 contacts are in quarantine (plus unimmunised contacts in Titirangi Private Kindergarten, Avondale College, Whakaaranga School and Auckland Academy of Dance). A contact is a person who has had sufficient contact with the person with measles to be at risk of developing measles.
• Five cases have now required hospitalisation
• Most cases have occurred in West Auckland with some spread to Central Auckland, North Shore, and Manukau.

ARPHS Medical Team continues to:

• receive notifications
• determine whether notifications are confirmed measles cases
• advise on isolation of cases, either until they will not be infectious or until it’s evident they were not a case
• identify contacts of suspected cases, determine contact’s immunity or susceptibility to measles, and advise quarantine, if appropriate
• telephone people in isolation and quarantine to encourage compliance
• work with schools and Early Childhood Education Centres (ECECs) to advise them on actions when there are confirmed cases
• manage new importations of measles
• manage public and health professional communications
• track the progress of the outbreak.

Immunisation Status of Confirmed Cases

Of the 64 cases, almost all are in unimmunised people. Several cases have unclear immunisation records, partial immunisation, or were immunised for the first time several days after exposure to an infectious case. This information is based on case interviews, GP information and NIR information.

From our records there may be two people who got measles despite having the correct number of immunisations for their age (if immunisation was ineffective then approximately 90 percent of cases would be in immunised people). Of the 64 cases, one has occurred in an infant under the age of 15 months, so too young to be vaccinated.

We are continuing to receive notifications of suspect cases indicating vigilance in primary care. During this outbreak, ARPHS has traced more than 400 contacts (not including those in schools and ECECs), most of the new cases are from transmission of the virus in schools and within households.

Background

• The initial cases were clearly linked to the measles cases first identified at Oratia District School, which started when a non-immunised pupil returned from abroad from England via Singapore and developed measles.
• During this outbreak there has been one unrelated case on the North Shore who developed measles on a recent trip to Thailand. ARPHS has warned other passengers, either directly for those sitting close to the case or via the media, who travelled on Thai Airways flight TG 491 from Bangkok to Auckland on 19/6/11 that they may have been exposed to the virus.
• Eleven cases have also not been linked directly to any of the cases from the initial outbreak in Oratia, though we suspect links in most of these.
• ARPHS has provided public health advice, including fact sheets and advisory information on exclusion and quarantine to the Ministry of Education to distribute to ECECs and schools to distribute to parents and staff.

ARPHS continues to:

• Encourage age appropriate immunisation, and catch up if overdue or uncertain.
• Send out regular measles updates and clinical and public advice to health professionals and primary health care providers
• Liaise closely with Ministry of Health, Immunisation Advisory Centre (IMAC) and the Ministry of Education (as required).
• Brief management staff of Auckland, Waitemata, and Counties Manukau DHBs on the outbreak.
• Remind doctors to notify suspected cases of measles.

Because international surveillance is reporting outbreaks of measles in several other countries, ARPHS is anticipating future cases in New Zealand.

Nga Mihi

Dr Richard Hoskins
Medical Officer of Health

Measles Fact Sheets http://www.arphsgovt.nz/notifiable/measles.asp

ENDS

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