Two new cases of measles were diagnosed this week with possible contacts around Brisbane. The people were infectious with measles while visiting the following places:

• Main Street Medical & Dental Centre, Beenleigh on Thursday, 3 October between 3:30pm and 7:40pm
• Seven Eleven Kingston South (Juers Street) 5 October, before 10 am on Saturday
• QE2 Hospital Emergency Department on Saturday, 5 October between 4 pm and 6 pm
• Logan Hospital Emergency Department from Sunday, 6 October from 10:30 am until 6:00 pm on Monday, 7 October.

People who may have come into contact with the patients (as per the above) need to be alert for symptoms, and those who are uncertain of their immunity to measles are urged to speak to their
GP immediately. Given the large numbers of people potentially exposed, further measles cases could present in Brisbane or elsewhere over the next two weeks.

Measles transmission can occur in medical settings. When a patient with suspected measles attends a medical facility, contacts (other patients/staff at the facility) are at risk of acquiring the infection.
The following recommendations will minimise the risk of transmission within facilities:

• Triage patients with fever and rash to a room that can be left vacant for 30 minutes after consultation. Where possible, examine cases of suspected measles at home.
• Ensure the patient is wearing a surgical mask while in the surgery, particularly if they need to walk through the surgery or shared areas.
• Ensure practice staff in contact with the suspected case are either fully vaccinated (2 doses of MMR) or have a serologically confirmed evidence of measles immunity.

The following guidelines are for the management of measles, check that the symptoms satisfy all of the clinical criteria:

1. generalised maculopapular rash (which usually begins on the face, before spreading to
   the rest of the body); AND
2.  fever of at least 38 degrees still present at the time of rash onset; AND
3. cough or coryza or conjunctivitis or Koplik’s spots.

•  Notify the public health unit immediately of any case satisfying the clinical criteria.
• Measles PCR of a naso-pharyngeal swab (in viral transport medium – not gel) and urine are appropriate in early illness.

Consider opportunistic vaccination for any unimmunised patients attending for any reason. All staff in your practice born on or after 1966 should have documented evidence of two doses of MMR.
Due to the ongoing increased measles transmission overseas, it is particularly important for travellers who are not immune or unsure to get vaccinated before leaving Australia. For more information on the measles please visit: http://disease-control.health.qld.gov.au/Condition/767/measles