Australia has been free of endemic measles since 2014. Could that change?

Just over a decade ago, endemic measles was declared eliminated from Australia.

But an infectious diseases specialist says that status could be under threat “if the current trend continues”.

So far this year, there have been 121 measles notifications across Australia — the highest number since 2019, when there were 284 notifications.

Of those, 36 have been in Western Australia, 34 in Victoria, 27 in New South Wales, and 19 in Queensland.

“We absolutely could undo the fact we have been declared free of endemic measles if this current trend continues,” Professor Paul Griffin said.

“We’re importing a significant number of cases, and if our vaccine rates continue to decline, we could see local transmission become well established and the risk of measles go up even further. 

“We need to make sure that doesn’t happen.”

Dr Paul Griffin says Queensland’s measles vaccination rate is too low. 

  (Supplied)

What is measles?

Measles is a highly infectious, acute viral illness.

It is transmitted through respiratory secretions such as coughing or sneezing, and even talking or breathing in the air of someone who was infected.

“It is so infectious you can be in the same room as someone who had measles even up to a few hours afterwards and still get infected,” Professor Griffin said.

“It’s truly airborne, it can travel through air conditioning, so you can even get measles [when you’re] not in the same room as someone who is infectious.”

What are the symptoms?

According to the Australian Immunisation Handbook, symptoms can include fever, malaise, cough, coryza (runny nose or inflammation) and conjunctivitis.

A rash usually begins on the face and upper neck and then becomes generalised.

Skin of a patient after three days of measles infection, date unknown. (Centres for Disease Control)

Professor Griffin said it can be “quite hard to pick up early” given the symptoms are so “non-specific” and “can mirror a whole range of much less significant infections”.

“Usually it starts with respiratory symptoms like a cough, runny nose and red eyes.

“It’s only a few days after those symptoms, the more typical things like the rash that usually starts on the face and spreads down becomes a lot more obvious.”

Professor Griffin said one in 1,000 to one in 10,000 measles cases are associated with “very serious complications”.

When was Australia declared endemic measles-free?

In 2014, the World Health Organisation said that Australia had eliminated endemic measles because an “endemic measles strain had not been circulating for several years”. 

Since then, dozens of measles notifications have been recorded across the country each year, peaking at 284 notifications in 2019.

Why are we seeing a rise again in cases?

Three regions in Queensland have reported a case of the highly infectious virus.

A public health alert was issued in Cairns, with a total of 11 cases identified by health authorities since the beginning of the month.

Mandatory mask wearing was brought in in select areas of the Cairns Hospital — including the intensive care unit, special care nursery, and maternity unit — after several cases had contact with the hospital.

Cairns Hospital has introduced a mask mandate in some vulnerable wards in light of the measles outbreak. (ABC News: Sharnie Kim)

Asked why cases were on the rise this year, Professor Griffin said it was probably due to a combination of factors.

“A lot of it will be linked to increases in international travel, but also our declining vaccination rates,” he said.

“When we see people who aren’t vaccinated travelling, they’re much more likely to acquire these sorts of infections.

“When they bring them back, if they come into contact with someone who is not completely vaccinated, then they’re very likely to pass it on.”

Professor Griffin said people need to be aware of these sort of risks when they travel and “take steps to reduce their chances of picking up things like this and bringing it back to Australia”.

“The other thing we really need to look at is boosting our vaccination rates.”

Two more measles cases in WA linked to Bali travel

WA Health urges people to check their vaccination status before travelling as measles is detected in two more travellers returning from Bali. 

Australian government figures show Queensland has the lowest immunisation coverage for one-year-olds of any state or territory, sitting at 90.35 per cent, which is below the target of 95 per cent.

Professor Griffin said Queensland’s vaccination rates were “certainly not high enough for a disease as significant as measles”.

Anyone who is unwell and displaying symptoms of measles is urged to seek medical attention and not attend work.