Measles - New Zealand still on high alert

The measles virus remains an ongoing concern in New Zealand as outbreaks continue to occur across the country. So far in 2019, 99 confirmed cases have been recorded primarily in Canterbury, Auckland, Waikato; with the Bay of Plenty, and Northland, with Southern DHB areas also reporting incidences.

Infants and preschoolers are most at risk of contracting the highly contagious and sometimes life-threatening measles virus which means it's more important than ever for early childhood educators to stay up-to-date about the disease and the best ways to prevent infection.

What is measles?

Measles is a highly infectious, yet preventable, airborne virus that affects both children and adults. Around 1 in 10 people with measles will need hospital treatment, and up to 30 per cent of all cases, usually children over five and adults over 20, will result in complications such as:

• Ear infections, possibly causing permanent hearing loss
• Diarrhoea
• Pneumonia
• Seizures
• Swelling of the brain, although rare, can cause permanent brain damage or death

Measles is the most common vaccine-preventable cause of death among children throughout the world and in pregnant women it may increase the risk of miscarriage, premature labour and low birth-weight babies.

Measles is a virus, which means that there is no real treatment other than rest, fluids and paracetamol for discomfort and in extreme cases hospital intervention may be required.

What are the signs and symptoms?

The virus usually starts around 7-18 days after exposure and early symptoms include:

• A fever
• A cough
• A runny nose
• Sore and watery ‘pink’ eyes
• Sometimes small white spots on the back inner cheek of the mouth
• Other diseases of the airways, like bronchiolitis and croup
• Ulcers of the eye, corneal ulcers
• Low platelets, idiopathic thrombocytopenic purpura

A blotchy rash will then appear around days three-seven of the illness, which tends to start on the face and behind the ears before moving down your body. It usually lasts about a week.

What about vaccinations?

Luckily measles is preventable via the measles, mumps and rubella (MMR) vaccine which is free in New Zealand to anyone born in or after 1969. Typically, children are immunised at the age of 12 months, with a second vaccination given around four years. In some cases, babies are immunised at six months if they're considered to be at very high risk, such as through exposure to measles via a family member.

These two doses are the most effective way to help protect individuals, their family and the wider community from contracting measles; with more than 95 per cent of people protected after one dose and 99 per cent after two doses. It takes around two weeks for the vaccine to become effective.

The only people who are unable to be immunised against measles are young babies, pregnant women, those with cancer, and people who could be negatively affected such as those who are under nourished or who could have an anaphylactic reaction. This group of people are therefore the most at risk of contracting the disease.

Young children with low immunity, such as those with leukaemia or who are undergoing chemotherapy are particularly vulnerable. While the virus can be dangerous with long-term effects for any child, for children in New Zealand with low immunity measles sadly has more than a 50 per cent death rate.

What can educators do?

Early childhood educators have a duty of care to protect the children in their service, as well as their families and staff members.

To prevent a measles outbreak in your service and the wider community you should:

• Educate staff – Ensure all educators and staff are informed about the virus and the threat it poses to young children, including information about vaccinations and the latest news on measles outbreaks in New Zealand.
• Ensure staff are vaccinated – Find out who is and who isn't vaccinated and offer them time off to be immunised. Herd immunity is the best way for a virus like measles to stop spreading.
• Communicate with parents – Send out newsletters, post flyers in your centre and talk to parents about the recent measles epidemics and what steps parents can take to protect children – including tips such as if you suspect measles to phone not visit your GP (being in the waiting room when infected can put others at risk). If there has been a confirmed case of measles in your service it is your duty to notify all parents, families and staff.
• Look for early warning signs – Be diligent about notifying parents when children have fevers, coughs, watery eyes or appear generally unwell. Advise that they stay at home to avoid spreading illness to other children. In the case of measles children need to be isolated for at least five days after the rash first appears which is when they are no longer contagious. Staff members who are unwell should also stay home, and women who are pregnant should take extra care around children who seem unwell.
• Practice good hygiene – Measles is spread through infectious droplets in the air from sneezing, coughing and talking, or by touching a surface infected with mucus or saliva. Maintain good cleaning practices and encourage children and staff to cover their mouths and use tissues when coughing and sneezing.

Thanks for the Ministry of Health for this information on measles.