newsCO.com.au–Why Australia still gets measles outbreaks despite eliminating the infectious disease in 2014

October 15, 2017

Almost every time a measles case emerges in Australia, multiple news agencies will run a news story. 

It’s important. Measles is one of the most contagious and potentially deadly infectious diseases worldwide, and disproportionately affects some of the most vulnerable people in the community, especially newborns, pregnant women and people with compromised immune systems.


Eliminating measles and rubella

A World Health Organisation video on the effects of measles and rubella and how both can be prevented by vaccination.

The virus can spread through the air from infected individuals who may not know they are sick. This year there have been 73 confirmed cases of measles, including 15 under-five-year-olds.

Health authorities in Sydney and Melbourne have mobilised to contain several outbreaks. A total of 28 people in NSW and 18 people in Victoria have been diagnosed with the condition this year. 

It’s a terrifying and potentially devastating disease for measles patients and their families.

But a rare one in Australia. Not so elsewhere. 

About 60,000 people in the western Pacific region are infected with measles every year, most often in areas that do not have Australia’s surveillance, rapid response systems, and high level of healthcare. 

As many as two to 15 per cent of children who are infected with measles die. 

After achieving a historical low rate of measles in 2012, 2013-16 brought a region-wide resurgence of the disease.

Last week the ministers of health and senior officials from 37 countries in the western Pacific at the World Health Organisation (WHO) regional committee meeting in Brisbane endorsed a new regional action plan to eliminate measles.

A major focus of the plan is to ensure all member states have an immunisation program capable of vaccinating every individual who needs it, including mass vaccination campaigns and boosting the number of children routinely vaccinated.

In 2014 WHO said Australia had eliminated measles, one of the first countries in the western Pacific to do so, along with Macao, Mongolia, and South Korea. The organisation confirmed there were no local strains of measles circulating in the Australian community, and surveillance systems rapidly detected and responded to new measles case.

Australia’s National Immunisation Program and free measles vaccination have been credited with measles elimination and strong herd immunity that makes it difficult for the disease to spread. 

But a central theme of the WHO meeting has been the rallying cry that no country is immune while its neighbours are suffering from communicable diseases. 

Measles can piggyback its way to Australia via travellers who have contracted the infectious condition in countries where it is still prevalent. 

“The increasing prevalence of measles in some parts of the world and the continued circulation of the virus in countries that are either close geographically to Australia or frequented by Australian travellers, means that there is a continual source of imported virus in Australia,” a  health department spokeswoman said. 

“This emphasises the need for continued high levels of vaccination coverage and continued vigilance through sensitive case surveillance and outbreak investigation and control,” she  said. 

All measles cases in NSW originated from infectious people who contracted the virus overseas, the director of Communicable Diseases at NSW Health Vicky Sheppeard said. 

In March, an outbreak that affected 17 people in Sydney’s west was traced back to an imported measles case from Bali. 

In 2012, a man returning from Thailand triggered 169 secondary cases as he visited family member’s homes, multiple doctors’ clinics and hospitals while highly infectious. 

“Unfortunately it was a young person who was not aware he was not fully vaccinated,” Dr Sheppeard said.

“But we don’t get secondary infections in most cases,” she said crediting rapid response protocols designed to contain outbreaks, including alerts to GPs, hospitals and the general public. 

Symptoms include fever, sore eyes and a cough followed by a non-itchy rash a few days later when the fever is still present. The incubation period can stretch from seven to more than 18 days. 

The measles vaccine is recommended on the National Immunisation Program at 12 months and again at 18 months.

Other action plans endorsed by committee members last week aim to eradicate rubella and mother-to-child transmission of HIV, hepatitis B and syphilis, and protect children from the harmful impact of food marketing.

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