An outbreak of measles cases in Australia has caused vaccination warnings. Are you at risk? – Health

Australians are invited to check their immunization history, with the number of measles cases in the country reaching a record in five years.

Nationally, 92 measles cases have been confirmed so far this year, compared with 103 for the whole of 2018 and 81 for the whole of 2017.

Only five years ago, Australia was declared measles-free and high vaccination rates helped fight the virus.

However, because of its strong contagion, measles outbreaks sometimes occur when people traveling abroad get infected and bring it back to Australia, said Kristine Macartney, director of the National Research Center and immunization surveillance.

"Globally, we are seeing hundreds of thousands of cases of measles, or even tens of thousands of deaths from measles," said Professor Macartney.

"Measles is incredibly contagious and where vaccination rates are not very high – over 90% – we risk seeing her ugly.

"Unfortunately, that's what's happening right now around the world … it's a pretty serious situation."

How is measles spread?

Measles is a highly contagious viral disease – spread by coughing and sneezing.

But it's not just the crackling that will transmit it. The measles virus can survive on surfaces up to two hours. So you can catch it by touching the same surfaces or breathing the same air as an infected person.

Measles is so contagious that almost nine in 10 people who come into contact with the virus will catch it if they are not immune.

It usually takes 10 days between a person exposed to the virus and a disease, which is also the time when it becomes contagious.

The first symptoms of measles include fever, cough, sore throat, runny nose, watery eyes and tiredness. About four days after the onset of the first symptoms, a rash will appear.

But it is not this seriously, right?

For most people, a case of measles usually means taking a few weeks of bed rest, plenty of fluid and paracetamol to relieve pain and fever, before recovering completely.

Sometimes, however, measles can lead to serious and sometimes life-threatening complications, including:

• Infection of the middle ear
• Diarrhea and vomiting (may cause dehydration)
• Pneumonia and other respiratory infections
• Problems for pregnant women
• Swelling of the brain

According to the Ministry of Health, about 1 in 15 people infected with measles contract pneumonia and 1 in 1,000 develop swelling of the brain that can lead to brain damage or death.

It is also possible for a person, several years after a measles infection, to develop a devastating and disabling brain disorder called subacute sclerosing panencephalitis, which is fatal.

In 2017, there were 110,000 measles deaths worldwide, mostly among children under five.

I think I'm immune …

In Australia, children routinely receive two doses of the measles, mumps and rubella (MMR) vaccine – once at 12 months and at 18 months. Two doses are recommended for complete protection.

While vaccination rates are high among children – 93.5% of 2-year-olds have received two doses of MMR vaccine – said Professor Macartney, many Australians aged 20 to 50 (born between 1966 and 1994) may not be fully vaccinated.

"The second dose of measles vaccine was not routinely administered until the early 1990s … so people may think that they received the two recommended doses, whereas in reality they did not do it, "she said.

The two-dose vaccination program was introduced in Australia in 1992 and school-based programs enabled children to be vaccinated until 1998 (when it became routine).

But Professor Macartney said many Australians born earlier may have forgotten the second dose, or even the measles vaccine.

"We know that in the eighties and early nineties, for example, our vaccination rates were as low as 70 percent," she said.

"So, people who were in the 80s and are now 30 years old may not be vaccinated against measles at all."

Australians born before 1966 do not have to worry, she said. They are probably naturally immune to the virus because of the magnitude of its circulation before the introduction of the National Immunization Program.

Get a booster shot

On Monday, Health Minister Greg Hunt urged all Australians to check their immunization history against measles and sign up for a catch-up vaccination if necessary.

"In particular, anyone wishing to go abroad and people born between 1966 and 1994 are at higher risk and should take steps to protect themselves and their communities," said Hunt.

You can check your immunization history with your doctor, via the Australian Immunization Registry or via a blood test.

"There is also no problem getting an extra dose of the measles vaccine if you are not sure how many doses you have received in the past," said Professor Macartney.

"It's a safe and extremely effective vaccine."

In addition to protecting yourself, Professor Macartney said that it was important to protect the most vulnerable members of the community who could not be vaccinated.

This includes infants under 12 months of age, people with immunodeficiency disorders, or immunosuppressive therapies such as chemotherapy, people taking certain medications, and people with chronic conditions.

"We rely on herd immunity to protect these most vulnerable people in our community," said Professor Macartney.

"The modeling shows that we absolutely need coverage rates above 95% for all age groups in order to prevent the type of spread of the observed virus," she said.

"Even in this case, we will always see these occasional outbreaks."

Australians under 20, refugees and other humanitarian actors of all ages, may receive measles vaccines free of charge as part of the national immunization program.

Anyone born in 1966 or after that date who has never received two measles vaccines is also eligible for a free MMR vaccine in all states and territories, with the exception of Tasmania.