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ABSTRACT
Measles is a highly contagious viral airborne disease, typically presenting with high fever, cough, conjunctivitis, and a maculopapular rash. No longer endemic in Australia, imported cases of measles do occur with a single case regarded as a public health emergency.
In January 2025, a returned traveller with measles was notified to the Centre for Disease Control (CDC) in Darwin, Northern Territory (NT); the first case in the NT since 2019 to be notified. An outbreak team followed national public health response guidelines. We interviewed the case to determine travel history, infectious period, potential contacts, and provided isolation advice. The electronic database, Research Electronic Data Capture (REDCap), was used for contact tracing to record contact details, vaccination status, and past infection history.
A total of 162 contacts were identified. We successfully contacted and completed follow up for 94% (153/162) of contacts. Of the total 162 contacts, 84% (136/162) were considered to be immune to measles. Of those immune, 90% (123/136) had received 2 doses of the measles-containing vaccine; 7% (9/136) were born before 1966; and 3% (4/136) reported a previous measles infection as a child. During the response, 90% (146/162) of contacts were provided advice only with no further action required, and 2% (4/162) were provided the measles-mumps-rubella (MMR) containing vaccine. Only 1 contact received normal human immunoglobulin (NHIG). The contact tracing was completed by 8 staff over a total of 12 hours on a weekend. We calculated the human resource cost for this outbreak response to be approximately $7,300. No further cases of measles were reported in the NT in the 2 months following this case notification.
This outbreak response highlights how high immunisation rates and a rapid, co-ordinated response using familiar electronic management systems, and staff preparedness training are crucial in preventing the onward transmission of measles. |
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