Local health experts urge vaccination in light of measles outbreaks

MEASLES is once again making headlines in Australia and around the world, and local experts are urging Northern Rivers’ residents – adults and children – to vaccinate.

After decades of low measles rates, it appears the potentially fatal disease is once again on the rise. Almost 100 people have been diagnosed with measles already this year, which is not far off the total of 103 people diagnosed for all of 2018. About a third of cases in Australia so far this year have been in New South Wales.

The National Centre for Immunisation Research (NCIRS) has warned that those born between 1966 and 1994 are at greater risk of contracting measles, and should check that they have received both doses of the vaccination.
The Department of Health has warned that anyone who is not fully vaccinated against measles is at risk of the highly infectious disease when travelling overseas, after cases worldwide have increased “substantially” in recent years.

Several countries are currently experiencing “severe and prolonged” measles outbreaks, including the US where in New York City a public health emergency has been declared. US President Trump has urged Americans to get vaccinated as a result of measles diagnosis being at its highest rate in 25 years.

Measles can cause serious, sometimes fatal, complications including pneumonia and swelling of the brain. In Australia, the majority of measles cases occur as a result of people becoming infected while travelling, or in contact with those who have been travelling.

Dr David Moss, a General Practitioner with Cape Byron Bay  Medical Centre with a special interest in community and public health, said he is concerned with the current increase in measles, around the world and locally.

“I have been following the various measles outbreaks in recent months,” Dr Moss said. “I have been struggling to understand the swing away from vaccinating against measles in numerous developed and developing countries, mainly as measles is so contagious and so easily prevented by immunisation.

“Vaccination resulted in a 75% decrease in world-wide deaths between 2000 and 2013, with about 85% of children worldwide being vaccinated as of 2014 (still 75,000 died in 2014). Australia’s vaccination program has been very effective in largely eradicating measles as a public health problem in Australia.”

Dr Moss said recently world-wide vaccine misinformation has been fuelling resistance to vaccination, and measles appears to be making a comeback in many parts of the world.

“The number of reported cases has increased by more than 30 per cent worldwide since 2016,” Dr Moss said.

Measles is spread by coughing and sneezing. It can cause serious lung infection and brain inflammation and, in a small number of cases, death (mostly in children under 5-years-old). Once you have measles, there is no treatment.

“Measles is highly contagious,” Dr Moss said. “On average, every person who contracts measles will infect 18 others.  Currently in Australia, the main risk is to under-vaccinated people who travel, especially to South-East Asia, and to those with whom they have contact upon return.

“The Byron and Mullumbimby local areas have a significantly lower immunisation rate for measles, compared to most of Australia, and I worry there is some risk of an outbreak should infected travellers come into contact with some local un-immunised groups.”

Dr Alex John, also of Cape Byron Medical, has extensive experience with low immunisation rates and the impact on the wider community.

“I worked and trained at the Royal Free Hospital in London,” Dr John says. “It is where the anti vax movement started. The medical students received a lecture from the now infamous Andrew Wakefield, (a discredited former doctor who went on to become anti-vaccine activist). Following the work of Andrew Wakefield and other like-minded individuals, the immunisation rate plummeted. A year or so later, measles ripped through the north London community. We had kids with encephalitis, one went blind, another deaf. I remember them well.

“I believe it is only a matter of time before the past repeats itself. People have forgotten. Look at the outbreak in New York at the moment. We are almost certain to have a similar outbreak here. It just takes one person on a plane from the US and the Northern Rivers will be in trouble.”

Dr John says understanding the motivation behind the anti-vaccination movement is key to improving vaccination rates and subsequent outcomes.

“I think it is too easy to blame the anti vax moment, which is simply a manifestation of a wider problem. We, the medical community, say ‘trust us, you need this’, but plenty of people don’t trust us, and they simply don’t immunise,” Dr John says.
“Maybe this is a reflection of the fact that we aren’t communicating well to certain parts of the public. We aren’t seen as being natural, and our research findings somehow don’t seem to resonate with the average person.
“I don’t have all the answers, but I do know we need to do better.”

Vaccination

In NSW measles, mumps, rubella (MMR) vaccine and measles, mumps, rubella, varicella (MMRV) vaccine are offered to children at 12 months and 18 months of age respectively, as part of the National Immunisation Program. Recent changes to NSW Health advice is that infants as young as 6 months of age can receive a measles vaccine ahead of travel to highly endemic areas and during outbreaks.
People born between 1966 and 1994 should not assume they have received two doses of vaccine, due to c

hanging vaccination schedules during this period. People who are unsure if they have received two doses of a measles vaccine in the past can safely be given another measles vaccine. NSW Health advises that the measles vaccine is available for free from GPs, for people born during or after 1966 to 1994 who do not have documented evidence of having received two doses.

Find further information about measles here

By Cape Byron Medical Centre