Imported Measles Outbreak in Midwest

The measles outbreak in the midwest (index case imported) has continued to spread within the Midwest community (particularly Limerick and adjacent areas).

Measles cases linked to this outbreak have been identified in Dublin, Clonmel, Galway and Clare.

In the Limerick region 28 confirmed cases have been notified and additional cases under investigation; 5 cases in the Sth Tipp area, 2 cases in Galway; one case in Dublin and others under investigation.

There is a continued risk of unrecognised transmission in the community.

Of note- a high proportion of cases are among the older teenage and older age groups- adults in 30-50 year age group are presenting

Further Information:

https://ndsc.newsweaver.ie/epiinsight/1qv34ih6ub810gkzp9yxn5?a=2&p=53187113&t=17517804

Actions requested:

• All clinicians are requested to maintain high levels of vigilance for measles at this time for both children and adults (oldest case is 50 years of age) presenting with fever/ rash illness, particularly if they had travel to regions where the outbreak cases are reported.
• Absence of travel to these areas does not indicate absence of measles risk. 
• Measles transmission may occur following unrecognised exposure in Ireland or overseas where measles outbreaks are occurring.
• All suspect cases should be notified immediately to Departments of Public Health 
• To prevent/minimise the risk of onward transmission in health care settings

GP Settings

• Suspect measles cases presenting to GPs should be immediately isolated away from other patients.
• Ideally all suspect measles cases should, if attending the GP practice be seen at time when other patients are not exposed (at end of surgery)

Referrals to Hospitals

GPs sending in patients to hospital should inform Emergency departments prior to patient arriving in order that immediate isolation and triage of all suspect measles cases is done to avoid transmission

In Accident and Emergency Departments

Isolation of all suspect cases prior to and while assement is taking place.

If Admitted

All suspect measles cases requiring admission should be isolated and confined to rooms pending laboratory results – reception staff need to be aware of same

Occupational Health Matters

All HCWs, both clinical and non-clinical, who have direct patient contact should be immune to measles https://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/chapter12.pdf

Additional documents included:

http://www.hpsc.ie/a-z/vaccinepreventable/measles/factsheet/