In November 2022, the World Health Organization (WHO) declared measles to be an imminent global threat. With six cases recently reported in Australia and health authorities expecting to see more cases emerge, we speak to medical virologist and infectious diseases physician, Professor Dominic Dwyer, to find out what this could mean for Australians.

“Measles is one of the most infectious diseases in humans. It is spread through coughing and sneezing and can be extremely serious. Complications can lead to hospitalisation and even death. Serious complications, including blindness, encephalitis, severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia, are more common in children under the age of 5, or adults over the age of 30. While deaths are much more common in developing countries, they are still reported in Australia.

“Despite being officially eradicated in Australia in 2014 thanks to immunisation, we can’t underestimate the risk of measles. The disease remains common in many parts of the world, and large outbreaks continue to occur, the effects of which can be widespread. With international borders now open again, the risk of measles in Australia is potentially increasing due to unvaccinated or under vaccinated people travelling to countries where there are outbreaks, or coming to Australia when they are infected,” said Prof Dwyer.

According to a joint publication by the WHO and the United States Centers for Disease Control and Prevention (CDC), in 2021 a record high of nearly 40 million children missed a measles vaccine dose: 25 million children missed their first dose, and an additional 14.7 million children missed their second dose.

“Worldwide declines in vaccine coverage, weakened measles surveillance, and continued interruptions and delays in immunisation activities due to COVID-19 have all lead us to where we are now. Seeing cases emerge in Australia recently highlights the importance of ensuring that everyone who is eligible has received two doses of measles vaccine. This is especially important for those born during or after 1966. By maintaining high rates of measles vaccination, we can reduce the spread of the disease within the community if the disease is imported into Australia, through herd immunity.

“Whilst measles is very contagious, it is almost entirely preventable through adequate vaccination. In Australia, two doses of measles vaccine are offered to children at 12 months and 18 months, free under the National Immunisation Program (NIP),” said Prof Dwyer.

New South Wales, Queensland and South Australia have all recently reported cases of measles:

• On 14 April, the Sunshine Coast Hospital and Health Service issued a public health alert for Gympie, the Mary Valley and Noosa after a case of measles was identified in the community.
• On 6 April, NSW Health issued a public health alert after a baby in Western Sydney was diagnosed with the disease and had spent time at a large number of venues while infectious. The baby is too young to be vaccinated against measles and had not been abroad.
• On 29 March, NSW Health issued a public health alert in Western Sydney after a baby tested positive to the virus. The infant acquired the infection overseas.
• On 28 March, South Australia reported its first case of measles since 2019 when a three-year-old boy was diagnosed with the disease. It is believed the boy, from regional SA, contracted the disease whilst overseas.
• On 28 March, two cases of measles were reported in a family on the Sunshine Coast. The family had recently returned from overseas.

Measles usually starts with cold-like symptoms, such as fever, sore eyes and a cough, followed three or four days later by a red, blotchy rash spreading from the head and neck to the rest of the body.

“If anyone thinks they have measles, they should stay home to stop them from spreading the infection. They should speak to their doctor right away, or call their local public health unit. A laboratory test is the best way to confirm the diagnosis. Information is available on the various State Departments of Health websites,” said Prof Dwyer.