Before you travel overseas, I challenge you to make a rash decision

By Dr Eddy Bajrovic, Medical Director, Travelvax Australia.

Imagine you travelled overseas and picked up an extremely contagious virus. 
One you could pass on to others even before you knew you’d been infected: To other guests at your hotel, passengers around you on your return flight, your immediate family and friends, and the people in your suburb or town.
This virus potentially could make you so sick that you need hospital treatment. If that’s not bad enough, local health authorities also have to spend thousands of dollars tracking down and treating everyone you and those you unwittingly infected have come into contact with. Ultimately, scores of people could be involved, their lives and health effected for weeks.

Have you guessed which virus I’m talking about?

It’s measles - the illness many people quite wrongly think of as a minor childhood disease involving little more than a body rash, an elevated temperature, and a week off school.

That’s far from the reality. Measles can cause serious illness - even death. On average the virus kills 164,000 people – 100,000 of them children – each year.

Australian cases linked to travel

Of the young Australian adults infected with measles this year, 1-in-3 required treatment in hospital.
Yet, measles has been all but eliminated in Australia. Of the 57 cases reported here to date in 2013, virtually all were ‘imported’ by travellers or linked to them.

Most recently, a measles-infected woman who travelled from China and an Australian man who returned from Europe with measles were directly linked to some of 15 cases reported in Victoria since early August. There have also been 14 recent outbreaks in Queensland linked to travellers.

The symptoms of measles – a fever, a runny nose, red and watery eyes, a cough, and an all-of-body rash – begin 7 to 21 days after exposure. 

But, those infected are contagious from around 4 days before the rash appears and for 4 days after.

So, most of the 57 Aussies infected to date this year didn’t know they’d been infected and passed on the virus before the first symptoms appeared.

Another misconception is that measles is a problem of developing countries: In fact, it has become a growing problem in developed countries in recent years, too.

Cases in Europe grew from around 7500 in 2009 to more than 30,000 in 2010. A major epidemic is currently occurring in the Netherlands among its vaccine-rejecting Orthodox Protestant communities, and the 1266 cases have included 90 cases of pneumonia, 1 case of encephalitis, and 82 hospital admissions.

In the USA, which is also considered to be free of measles, there has been 159 cases to date this year – it’s highest figure since 1996. A quarter of the American cases were brought home by travellers, while two-thirds were the result of the virus being introduced to local communities with low vaccination rates.

Take the travel challenge

So, before you travel overseas, I challenge you to ‘do the right thing’ by yourself, your loved ones, and your community by ensuring that you don’t bring home measles.

How? By confirming that you’ve either:

- Had measles infection, or
- Had 2 documented doses of live virus measles vaccine, such as the MMR (Measles, mumps, rubella) vaccine, in the past.

Australian’s immunisation guidelines advise that people born during or since 1966 who have not received 2 doses of MMR vaccine should receive at least one dose before departure and a second on their return to complete the course.

There’s a safe, effective vaccine

If in doubt about your vaccination status, have the vaccine.

It’s safe, effective, and provides long-term protection against all three diseases. (Protection against rubella is particularly important for women in their child-bearing years as infection just before conception or in early pregnancy could result in miscarriage, foetal death or congenital defects known as congenital rubella syndrome.)

Contrary to some misguided public opinion, measles vaccine (MMR) does not cause autism and can be given to children and adults who are allergic to eggs.

Travelvax Australia recommends travellers check their immunisation status for measles and childhood diseases such as diphtheria, whooping cough, mumps, and polio 6 weeks before departure.

It takes just one infected passenger…

In any setting, but especially on an aircraft, measles is transmitted
when an infected person sneezes or coughs fine droplets containing the virus into the air. Because they don’t always remember to cover their mouths, children can be the worst offenders in spreading measles.

It just takes one passenger with measles to expose you and others on your flight. 

Those passengers at highest risk are usually those seated within a two seats of the infected person, but those passing by as they stretch their legs or walk to the toilets are vulnerable to infection, too.

Here are some more facts on measles to help convince you that the potential risk is real and that you have a ‘duty of care’ when you travel overseas.

- Each year about 20 million people get measles worldwide.

- While it’s often a mild disease, it can also cause serious illness - even death. 1-in-20 children with measles will get pneumonia, and about 1-in-1000 will get encephalitis, an inflammation of the brain. (Measles can also result in a severe degenerative disease of the central nervous system disease 7-10 years after the initial measles infection. Subacute sclerosing panencephalitis (SSPE) produces mental and motor deterioration progressing to coma and death. SSPE is rare (1 per 100,000 cases) but preventable through vaccination.) 

- As well as the unvaccinated, those at highest risk of severe illness from measles include pregnant women, infants under 6 months of age, and those with weakened immune systems.

Remember to mention your travel history

If you have travelled overseas, watch your health for 3 weeks after you return.

If you, a member of your family, or a travelling companion gets sick with a rash and fever, call your doctor and list the symptoms. Because measles is so contagious, special arrangement may be made to see you, to avoid infecting others at your usual medical centre or hospital emergency department.

Be sure to mention that you’ve travelled overseas.

By offering your travel history, you will help your doctor think about diseases that no longer normally occur in Australia. Like measles.

Read more on measles and other routine vaccine-preventable diseases. For more travel health advice, call Travelvax Australia free, no-obligation advisory service on 1300 360 164.