16 March 2017

Measles warning for Bali travellers

Western Australians heading to Bali are being urged to make sure they have been appropriately vaccinated against measles, following a recent surge of cases contracted on the island.

WA Health Medical Epidemiologist Dr Gary Dowse said measles infection had been confirmed in four adults, from different travelling parties, after they returned to WA from Bali over the past fortnight.

Most other Australian states had also reported cases in Bali travellers in the past few weeks. 

“Unfortunately, it is not unusual for Australians to be infected with measles overseas,  including in Bali,  but the increase in the number of cases in the past month suggests there may be a significant measles outbreak currently underway in Bali,” Dr Dowse said. 

“There have been more than 20 separate importations of measles from Bali to WA since 2013, including six already this year, which is more than for any other overseas travel destination.

“The first Bali cases this year were in two children who had not been vaccinated, which led to an outbreak with four people being infected in WA, three at a local hospital in January.”

Dr Dowse said high vaccination coverage meant naturally occurring measles had been eliminated from WA for around 20 years but occasional cases and small outbreaks still occurred – associated with tourists or WA residents who were infected overseas.

He added that every imported measles case was treated as a public health emergency because of the risk of local spread, including to those most vulnerable to infection such as infants too young to be vaccinated, pregnant women and those with compromised immune systems.

Travellers returning from Bali (or other countries) who developed a fever with other symptoms including cough, runny nose, sore red eyes and a rash – within two to three weeks of returning home – should consult their doctor.

“Anyone who thinks they might have measles should call ahead so that they can be isolated when they arrive at the GP surgery or Emergency Department, to prevent infecting other patients and staff,” Dr Dowse said.

“Measles is contagious for about four days before and after the development of the rash. Children and adults who have been unwittingly exposed are at risk of developing measles if they are not immune.”

Measles is a serious and highly contagious viral illness spread by tiny droplets released when infected people cough and sneeze.

Early symptoms include fever, cough, runny nose and sore eyes, followed by a red blotchy rash about three days later. The rash usually starts on the face and spreads to the rest of the body.

Complications following measles can be serious and include ear infections and pneumonia in about 10 per cent of cases. Around 40 per cent of cases require hospitalisation and about one person in every 1,000 will develop encephalitis, inflammation of the brain. Deaths from measles remain common in developing countries.

Measles vaccine is currently given to children at 12 and 18 months of age. People born during or after 1966 should make sure they have had two documented doses of a measles vaccine at some stage in their life, especially before travelling overseas, including to Bali. If they are not sure if they have been vaccinated in the past, they should see their doctor for a vaccination before they leave.


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