Measles outbreak calls for vaccination vigilance

The vast majority of children that get measles will overcome it, but in some cases it can prove fatal. Dave Haygarth/Flickr

As a fail-safe mechanism, parents should be required to show proof their children have been immunised against measles before they are allowed to start school, says infectious diseases expert and director of the National Centre for Immunisation Research and Surveillance (NCIRS) Peter McIntyre.

The suggestion comes after a measles outbreak in New South Wales, said to be the worst in 14 years, and warnings from the Northern Territory Health Department after two cases were reported in one week.

NSW Health last week said it had stepped up efforts to combat the highly contagious disease, after a total of 145 cases were reported this year, more than a third of which were diagnosed in the last month.

“To start primary school in the US if you don’t have your paperwork showing two measles shots they say "sorry, come back when you have the paperwork,” Professor McIntyre said.

“That might be seen as a bit tough…but on the other hand it does really work.”

Despite NSW Health saying the outbreak is the worst in more than a decade, Professor McIntyre said Australia had a high level of immunity to measles, with the latest outbreak the result of travellers acquiring measles overseas, and families with children who are not immunised.

These families may have been born overseas, have not been able to access immunisation services, or less commonly are “objectors”, and are living in areas with high population density.

He said there were also cases of babies aged less than 12 months - too young for the first vaccine dose - contracting measles.

Given the relatively minor number of measles cases seen in Australia in the last decade, Professor McIntyre said doctors didn’t readily diagnose the viral disease.

“It hasn’t been around for such a long time, in a lot of circumstances people turn up in hospitals and the possibility of measles isn’t realised until it’s too late.”

Robert Booy, professor at the University of Sydney and head of clinical research at the NCIRS, agreed.

“Doctors these days find it very hard to diagnose it because they’re not used to seeing it.”

Nevertheless, he said public health units had responded admirably, were taking the issue on as a priority and advising GPs to put suspected cases into a separate waiting room and take other practical measures like wearing a mask.

NSW Health has set up special clinics offering the measles vaccine for free to help combat the outbreak, but Professor McIntyre said other measures might be required.

“It’s difficult to find these people and get them immunised, that’s the reason they’re susceptible in the first place.

"They’re not easy to find and won’t necessarily turn up in clinics for the same reasons they aren’t immunised in the first place.”

Professor McIntyre said social media sites like Facebook may be of more use than clinics in helping community groups spread the word about the importance of immunisation and find unimmunised people.

Professor Booy said newly arrived migrants, travellers returning from overseas or students heading overseas for gap years should all be targeted.

But he played down the size of the current outbreak, pointing out surveys from blood samples showed about 94% of the population were immune to measles.

“We’re going to have these small outbreaks, nothing like we used to have. In the bad old days we had peaks every two years.”

With Australians now commonly given two doses of MMR (Measles, Mumps and Rubella) vaccine, Professor Booy said he didn’t believe mandatory approaches were required.

“We do so well with voluntary approaches…More people vote for MMR vaccine than Liberal, Labor and Greens combined.”

Professor Booy added that while Australia was doing well with childhood vaccinations, there was less uptake in adults.

NSW Health said it was safe to have the vaccine more than twice, so people who were unsure of their immunity should get vaccinated.