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Travel Health Alert: Measles Outbreak in NZ

Posted by feww on July 5, 2009

Measles Outbreak in Christchurch, NZ!

The following Travel Health Alert was relayed to FEWW by Blogger TEAA

New Zealand Travel Health Warning: Measles Outbreak in Christchurch!

Global Health Alert  Bulletin # 28  Outbreak of potentially lethal measles infection in Christchurch!

Four Christchurch Boys’ High School students were found to have measles infection last week, with another case suspected.

Canterbury health officials have now identified an additional six likely cases of the measles in the region, said Medical Officer of Health Dr Cheryl Brunton.

No further information has been released.

See also:

More About Measles Infection:

The following information about Measles is from CDC website:

Measles Advisory– Measles is a highly infectious disease that can result in severe, sometimes permanent, complications. The disease is no longer common in the United States, but it remains widespread in most countries of the world. Recent outbreaks in the United States highlight the ongoing risk of measles importations from other countries by people who travel. These outbreaks also highlight the impact vaccination has in preventing measles. As the new school year begins, parents should consider the importance of vaccination in protecting their children, themselves, and others against this highly contagious disease. Further information regarding recent U.S. measles outbreaks is available in an April 2008 CDC Health Advisory and in an August 2008 Morbidity and Mortality Weekly Report, Update: Measles — United States, January–July 2008.

Measles Virus

This thin-section transmission electron micrograph (TEM) revealed the ultrastructural appearance of a single virus particle, or “virion”, of measles virus. The measles virus is a paramyxovirus, of the genus Morbillivirus. It is 100-200 nm in diameter, with a core of single-stranded RNA, and is closely related to the rinderpest and canine distemper viruses. Two membrane envelope proteins are important in pathogenesis. They are the F (fusion) protein, which is responsible for fusion of virus and host cell membranes, viral penetration, and hemolysis, and the H (hemagglutinin) protein, which is responsible for adsorption of virus to cells.

There is only one antigenic type of measles virus. Although studies have documented changes in the H glycoprotein, these changes do not appear to be epidemiologically important (i.e., no change in vaccine efficacy has been observed). See PHIL 8429 for a black and white version of this image.

Prior to 1963, almost everyone got measles; it was an expected life event. Each year in the U.S. there were approximately 3 to 4 million cases and an average of 450 deaths, with epidemic cycles every 2 to 3 years. More than half the population had measles by the time they were 6 years old, and 90 % had the disease by the time they were 15. This indicates that many more cases were occurring than were being reported. However, after the vaccine became available, the number of measles cases dropped by 98 % and the epidemic cycles drastically diminished. Measles virus is rapidly inactivated by heat, light, acidic pH, ether, and trypsin. It has a short survival time (<2 hours) in the air, or on objects and surfaces. Credit : CDC/ Courtesy of Cynthia S. Goldsmith; William Bellini, Ph.D.

What’s Measles?

A respiratory disease caused by a virus, which normally grows in the cells that line the back of the throat and in the cells that line the lungs.

Symptoms

Rash, high fever, cough, runny nose, and red, watery eyes (lasts about a week).

Complications

Diarrhea, ear infections, pneumonia, encephalitis, seizures, and death

Approximately 20% of reported measles cases experience one or more complications. These complications are more common among children under 5 years of age and adults over 20 years old.

Measles causes ear infections in nearly one out of every 10 children who get it. As many as one out of 20 children with measles gets pneumonia, and about one child in every 1,000 who get measles will develop encephalitis. (This is an inflammation of the brain that can lead to convulsions, and can leave your child deaf or mentally retarded.) For every 1,000 children who get measles, one or two will die from it. Measles can also make a pregnant woman have a miscarriage, give birth prematurely, or have a low-birth-weight baby.

In developing countries, where malnutrition and vitamin A deficiency are prevalent, measles has been known to kill as many as one out of four people. It is the leading cause of blindness among African children. Measles kills almost 1 million children in the world each year.

Transmission

Spread by contact with an infected person, through coughing and sneezing (highly contagious)

The disease is highly contagious, and can be transmitted from 4 days prior to the onset of the rash to 4 days after the onset. If one person has it, 90% of their susceptible close contacts will also become infected with the measles virus.

The virus resides in the mucus in the nose and throat of the infected person. When that person sneezes or coughs, droplets spray into the air. The infected mucus can land in other people’s noses or throats when they breathe or put their fingers in their mouth or nose after handling an infected surface. The virus remains active and contagious on infected surfaces for up to 2 hours. Measles spreads so easily that anyone who is not immunized will probably get it, eventually.

Vaccine

Measles vaccine (contained in MMR, MR and measles vaccines) can prevent this disease.

The MMR vaccine is a live, attenuated (weakened), combination vaccine that protects against the measles, mumps, and rubella viruses. It was first licensed in the combined form in 1971 and contains the safest and most effective forms of each vaccine.

It is made by taking the measles virus from the throat of an infected person and adapting it to grow in chick embryo cells in a laboratory. As the virus becomes better able to grow in the chick embryo cells, it becomes less able to grow in a child’s skin or lungs. When this vaccine virus is given to a child it replicates only a little before it is eliminated from the body. This replication causes the body to develop an immunity that, in 95% of children, lasts for a lifetime.

A second dose of the vaccine is recommended to protect those 5% who did not develop immunity in the first dose and to give “booster” effect to those who did develop an immune response.

Who Needs the Vaccine

Does my child need this vaccine?

The young boy pictured here, displayed the characteristic maculopapular rash indicative of rubella, otherwise known as German measles, or 3-day measles. Rubella is a respiratory viral infection characterized by mild respiratory symptoms and low-grade fever, followed by a maculopapular rash lasting about 3 days. In children there may be no significant respiratory prodrome and the illness may not be diagnosed since the rash may be mild and mimic other conditions. It is estimated that 20-50% of infections are subclinical. Complications occur more frequently in adult women, who may experience arthritis or arthralgia, often affecting the fingers, wrists and knees. These joint symptoms rarely last for more than a month after appearance of the rash.

The rubella vaccine is a live attenuated (weakened) virus. Although it is available as a single preparation, it is recommended that in most cases rubella vaccine be given as part of the MMR vaccine (protecting against measles, mumps, and rubella). MMR is recommended at 12-15 months (not earlier) and a second dose when the child is 4-6 years old (before kindergarten or 1st grade).

Rubella vaccination is particularly important for non-immune women who may become pregnant because of the risk for serious birth defects if they acquire the disease during pregnancy.

Birth defects if acquired by a pregnant woman: deafness, cataracts, heart defects, mental retardation, and liver and spleen damage (at least a 20% chance of damage to the fetus if a woman is infected early in pregnancy). Image and caption: CDC.

Children should get 2 doses of MMR vaccine:

  • The first dose at 12-15 months of age
  • The second dose at 4-6 years of age

These are the recommended ages. But children can get the second dose at any age, as long as it is at least 28 days after the first dose.

For additional details, consult the MMR Vaccine Information Statement {PDF}  and the Childhood Immunization Schedule.

As an adult, do I need this vaccine?

You do NOT need the measles, mumps, rubella vaccine (MMR) if:

  • You had blood tests that show you are immune to measles, mumps, and rubella.
  • You are a man born before 1957.
  • You are a woman born before 1957 who is sure she is not having more children, has already had rubella vaccine, or has had a positive rubella test.
  • You already had two doses of MMR or one dose of MMR plus a second dose of measles vaccine.
  • You already had one dose of MMR and are not at high risk of measles exposure.

You SHOULD get the measles vaccine if you are not among the categories listed above, and:

  • You are a college student, trade school student, or other student beyond high school.
  • You work in a hospital or other medical facility*.
  • You travel internationally, or are a passenger on a cruise ship.
  • You are a woman of childbearing age.

For additional details, consult the MMR Vaccine Information Statement and the Adult Immunization Schedule.

See also:  Healthcare Personnel Vaccination Recommendations

More on Vaccines Page

One Response to “Travel Health Alert: Measles Outbreak in NZ”

  1. Deans said

    good information ..thanks

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