A generalised maculopapular rash, starting on the head and neck and then spreading to the rest of the body.
Notify public health immediately
Notify the Medical Officer of Health as soon as you suspect measles – do not wait for a laboratory confirmation.
Post-exposure MMR vaccination and exclusion
Health professionals should refer to the Communicable Diseases Manual for detailed guidance on public health management of measles contacts. If support is required, health professionals should contact their local public health service.
Post-exposure MMR vaccination
Post-exposure MMR vaccination
We recommend prompt vaccination with MMR for all contacts without acceptable evidence of immunity.
Unvaccinated or partially vaccinated (those with only one documented dose of MMR) contacts should be vaccinated promptly with MMR. MMR given within 72 hours of exposure may reduce the risk of developing disease. If immunisation is given more than 72 hours after exposure it is less likely to prevent infection.
Further cases of measles may occur if someone is already incubating the disease, but the liberal use of MMR should reduce the likelihood of ongoing transmission.
It is safe to give MMR to people who are already immune, and we recommend that contacts without evidence of immunity should be vaccinated promptly.
Evidence of immunity
Evidence of immunity
Acceptable evidence of immunity is:
anyone born before 1 January 1969
documentation of immunity (positive measles IgG) or previous infection
for children aged 12 months to under 15 months: documentation of at least one dose of measles-containing vaccine after their first birthday
for individuals aged 15 months and older: documentation of two doses of measles-containing vaccine, given at least one month apart and given from 12 months of age:
Note that from 1 October 2020 the MMR vaccine was moved from being given at 15 months and 4 years to being given at 12 months and 15 months.
Exclusion from school or work of contacts having received MMR
Exclusion from school or work of contacts having received MMR
Vaccination with MMR post-exposure cannot guarantee protection.
Previously unvaccinated contacts who have received their first documented MMR vaccination post-exposure (regardless of timeframe) should quarantine (i.e., stay home unless seeking health care) from seven days after first exposure until 14 days after their last exposure, unless they subsequently provide acceptable evidence of immunity.
Partially vaccinated contacts (those with only one documented dose of MMR):
Will not be requested to quarantine, but
Should be excluded from higher risk settings*, unless the setting is one where all others present have acceptable presumptive evidence of immunity, and
The contact will continue to be monitored for signs and symptoms consistent with measles for at least 14 days, and
A second MMR needs to be administered as soon as possible (but at least four weeks from the first dose).
* Higher risk settings include early childhood education centres, healthcare, and other settings where there may be high levels of contact and with susceptible people who may be more prone to developing severe disease if infected.
Previously partially vaccinated contacts who receive their second dose of MMR within 72 hours after first exposure are not considered susceptible and will not be excluded from high risk settings.
Prevent transmission
Measles patients are infectious from four days before the rash appears until four days after the rash appears (counting the day of rash onset as day 0).
Implement Infection Prevention and Control measures, for example:
Identify suitable triage and isolation areas for suspect measles cases. Ideally an AIIR otherwise a single room with the door kept closed.
Allow only immune staff to have contact with the patient.
Staff to wear a P2/N95 particulate respirator and eye protection.
Be prepared for suspected measles cases who may not have called ahead, for example, by placing signs, hand gels and surgical masks at waiting room entrances or reception desks.
Promote immunisation
With active measles cases increasing around the world, and falling vaccination rates, Aotearoa New Zealand is at very high risk of a measles outbreak.
Not enough people living in New Zealand are immunised against measles – just 1 case could start an outbreak. We need at least 95% of people to be immunised to prevent this.
Immunisation is the best protection against measles. It’s more important than ever for people to check they are protected.
Health NZ has developed printable and shareable resources for primary care, after-hours clinics and emergency departments, businesses and community groups. These include a fact sheet, posters, and social media tiles.
The measles provider toolkit brings together all the measles messaging and resources together in one place.
Measles immunisation, prevention, and alert resources provider toolkit
Measles immunisation, prevention, and alert resources provider toolkit
This toolkit brings together resources and messaging about measles in one place.
It is designed to support health providers and others to communicate measles prevention messages in their communities.