Published Date: 2001-02-16 23:50:00
Subject: PRO> Measles - Australia (Victoria)
Archive Number: 20010216.0309

MEASLES - AUSTRALIA (VICTORIA)
******************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

See Also

Measles - South Korea 20010210.0271
Measles - USA (Seattle, WA) 20010210.0270
1999
----
Measles - Australia ex Indonesia 19990319.0433
Measles - Australia ex Indonesia (02) 19990329.0500
Measles advisory, travelers - Indonesia (Bali) 19990303.0305
1997
----
Measles - Fiji 19971016.2133
Measles - French Polynesia 19970215.0385
Measles - French Polynesia (02) 19970217.0390
Measles - New Zealand 19970725.1574
Measles imports threaten eradication efforts - Ame... 19971205.2433
Date: Fri 16 Feb 2001 12:08:23 +1000
From: Ross Andrews <Ross.Andrews@dhs.vic.gov.au>

Measles Outbreak Among Young Adults in Australia
------------------------------------------------
As of Fri 16 Feb 2001, 31 laboratory-confirmed cases of measles have been
identified in Victoria, Australia. All but one of these (a 10 month-old
female) have been between 15 and 34 years of age. The previous measles
outbreak in Victoria affected a similar age group (ref. 1).
Young Australian adults born between January 1970 and December 1983 are at
greater risk of measles infection because they have either not had wild
measles virus infection or have not been adequately immunized.
Measles-containing vaccines were first available in Australia in 1968 and a
2-dose MMR (Measles-Mumps-Rubella) vaccination program was introduced in
1994. Very few of those within this age group are likely to have received 2
doses of a measles-containing vaccine (ref. 2). As with the 1999 outbreak,
the hospitalization rate among this age group has been high: 17 cases (57
per cent) have been hospitalized.
The primary case in the current outbreak was a 19 year-old male with no
documented history of previous vaccination, who had returned to Sydney on 4
Jan 2001 after spending a holiday in India. He visited Melbourne, Victoria
from 17 to 20 Jan 2001 during his infectious period. Onset of rash in the
primary case was 20 Jan 2001. Onset of rash in the remaining cases was
between 28 Jan and 13 Feb 2001. In total 8 cases have been directly linked
to the primary case, including the 10 month-old child who had attended the
same restaurant on the same night as the primary case. The 3 most recent
cases (rash onset between 9 Feb 2001 and 13 Feb 2001) appear to represent
the next wave of transmission. Of these 3, 2 are known to have attended the
same night club on the same night.
Measles virus RNA has been harvested from 13 of the cases by the Victorian
Infectious Diseases Reference Laboratory. While initial analysis of the
virus strain places it within genotype "D," subsequent tests will allow
more specific genotyping. Virus culture in B95a cells has yielded at least
5 isolates and is ongoing.
References:
1. Lambert SB, Morgan ML, Riddell MA et al. Measles outbreak in young
adults in Victoria, 1999. MJA 2000;173:467-471.
2. Communicable Diseases Network Australia New Zealand. Guidelines for the
control of measles outbreaks in Australia. Communicable Diseases
Intelligence Technical Report Series No 5. Canberra: Commonwealth
Department of Health and Aged Care, 2000.
--
Ross Andrews
Acting Surveillance and Response Team Leader
Communicable Diseases Section
Public Health Division
Department of Human Services
17 / 120 Spencer Street
Melbourne, Victoria 3000
<Ross.Andrews@dhs.vic.gov.au>
[In general ProMED-mail does not categories measles as an emerging disease,
but individual reports are considered on the basis of their intrinsic
interest. In principle, we appreciate reports from official sources, and
hope that official sources will also send us reports of outbreaks of
emerging infectious diseases.
According to the standardized nomenclature recommended by WHO for
description of wild-type measles viruses (WER, 1998; 73: 265-272), 8 clades
can be discriminated by phylogenetic analysis, and are further divisible
into at least 15 distinct genotypes. Some clades are represented by a
single genotype, whereas others (such as clade D) contain multiple
genotypes (designated D1, D2...etc.). Further characterization of these
Australian isolates may confirm the inference that the virus was imported
into Australia by the index case. - Mod.CP
................cp/pg/ds
*##########################################################*
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
############################################################
############################################################