Re: AU: 2010 Measles alerts/cases
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Archive Number</TD><TD noWrap align=left>20100709.2299</TD></TR><TR><TD noWrap align=right>
Published Date</TD><TD noWrap align=left>09-JUL-2010</TD></TR><TR><TD noWrap align=right>
Subject</TD><TD noWrap align=left>PRO/EDR> Measles - Australia ex South Africa</TD></TR></TBODY></TABLE>
MEASLES - AUSTRALIA ex SOUTH AFRICA***********************************A ProMED-mail post<
http://www.promedmail.org>ProMED-mail is a program of theInternational Society for Infectious Diseases<
http://www.isid.org>Date: Fri 9 Jul 2010From: Krispin Hajkowicz <
Krispin.hajkowicz@nt.gov.au> [edited]
Laboratory-confirmed case of measles in a returned traveller from the FIFA World Cup in South Africa----------------------------------------------------------------------
A 24-year-old male travelled from Australia to South Africa. He did not seek pre-travel medical advice, but had been immunised as a child. He attended the following world cup matches:
England vs USA - Rustenberg 12 Jun 2010
Australia vs Germany - Durban 13 Jun 2010
England vs Algeria - Cape Town 18 Jun 2010
Australia vs Ghana - Rustenberg 19 Jun 2010
Australia vs Serbia - Nelspruit 23 Jun 2010
The patient did not fly during the period of communicability. He did however attend 2 family practitioner offices and a cinema in Darwin, Australia when infectious to others. He had a clinical presentation of fever, macular/confluent rash, prominent respiratory symptoms, conjunctivitis, and Koplick's spots. Nose and throat swabs were positive for measles virus RNA. He is expected to make a complete recovery.
Given that the patient's symptoms first appeared on Fri 2 Jul 2010 and the rash appeared on Sun 4 Jul 2010, it could be speculated that he became infected in either Cape Town or Rustenberg. Transmission of measles within domed [roofed] sporting arenas has been described previously (1).
Given the large current outbreak of measles in South Africa (2), clinicians and public health officers should be alert to possible presentations of measles in returned travellers from the FIFA [Federation Internationale de Football Association] World Cup. Additional transmission may also have occurred in Darwin, Australia in late June/early July 2010. Young adults, such as this case, are at risk of measles infection as they may have only had one immunisation and consequently may have had insufficient protection.
References----------1. Ehresman KR, Hedberg CW, Grimm MB, et al: An outbreak of measles at an international sporting event with airborne transmission in a domed stadium. J Infect Dis 1995; 171(3): 679-83 [abstract available at<
http://www.ncbi.nlm.nih.gov/pubmed/7876616>].2. Baleta A: South Africa prepares for the football World Cup. Lancet Infect Dis 2010; 10(6): 373-4.--Krispin HajkowiczInfectious Diseases PhysicianDarwin, Northern TerritoryAustralia<
Krispin.hajkowicz@nt.gov.au>[According to the WHO Measles fact sheet (<
http://www.who.int/mediacentre/factsheets/fs286/en/index.html>) the 1st sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts 4 to 7 days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts, usually on the face and upper neck. Over about 3 days, the rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 18 days). It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts. The virus remains active and contagious in the air or on infected surfaces for up to 2 hours.As of 28 Apr 2010, 12 227 cases of measles had been confirmed in an outbreak that started in South Africa in January 2009. Cases have been reported from all 9 provinces of South Africa, but the outbreak has been concentrated in the northeast of the country. A national programme to immunise children against measles took place between 12 and 23 Apr 2010.Travellers to South Africa to attend the FIFA World Cup were officially advised by the UK Health Protection Agency to ensure that they were up to date with the British Schedule of vaccination, which includes measles, mumps, and rubella (MMR)<
https://www.nathnac.org/pro/clinical_updates/2010worldcup_150210.htm>. The case described above justifies the appropriateness of this travel advice.A map showing the locations of the 9 provinces of South Africa can be accessed at<
http://www.sa-venues.com/maps/south-africa-provinces.htm>.The HealthMap/ProMED-mail interactive map of Australia is available at<
http://healthmap.org/r/00cS>. - Mod.CP][see also:Measles - Africa (10): South Africa (WC)
20100408.1132Measles - Africa (08): South Africa (WC), Zimbabwe (BU)
20100302.0692Measles - Africa (07): South Africa
20100212.0503Measles - Africa (05): South Africa (Cape) alert
20100202.0358Measles - South Africa (06): (GT) prisoners
20091026.3707Measles - South Africa (05): (GT)
20091013.3532Measles - South Africa (04): (GT)
20091002.3435Measles - Africa (03): South Africa (Johannesburg)
20090929.3399Measles - Africa: Namibia, Angola, South Africa
20090903.3105Measles - South Africa: (GT), alert
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