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We've become used to looking out for symptoms like a runny nose, cough and fever as signs of a Covid-19 infection.
But now health authorities are warning people across the east coast to be on high alert for measles.
At least three cases of the highly infectious disease have been recorded at sites in Sydney, Melbourne, Brisbane and the ACT, likely brought to Australia from overseas.
Symptoms usually start as a fever, sore eyes and a cough, and then develop into a red, patchy rash that begins in the head and spreads through the body.
Dr Christine Selvey is the Director of Communicable Diseases at New South Wales Health.
She says measles one of the most infectious communicable diseases that exists.
“And it spreads through aerosols in the air. It's so infectious that sometimes people have actually acquired measles from coming into the same room that a person with measles was, two hours after the person with measles actually left the room.”
Dr Selvey also says it's "very clever" at picking out the one or two people in a big crowd who aren't immune.
While Australia is generally protected by very high vaccination rates - over 95 per cent - there are always people in the community who can't be vaccinated.
Dr Selvey explains those at risk include people who are immuno-compromised or have another kind of health condition, and very young children.
“We need everybody to be protected to protect those people that can't be vaccinated, and also children aged between 6 months of age and 12 months of ages, before they get their first vaccine, their mothers' antibodies are just wearing off in their systems so those young babies are vulnerable to measles. It can lead to a nasty pneumonia, sometimes it can cause encephalitis - and then rarely - there's a very severe condition called pan-encephalitis, that occurs seven to eight years after measles infection and that usually results in death.”
The last few years has seen a global decline in all kinds of vaccination programs, leading to an explosion of measles cases worldwide.
The World Health Organisation ((WHO)) has issued a warning about its spread after the number of annual cases in Europe jumped from 941 to more than 42,000 in just 12 months.
Dr Katherine Gibney is an infectious diseases and public health doctor at the Doherty Institute and Royal Melbourne Hospital.
“Throughout the world there are many countries - and particularly those low-income countries where the health infrastructure is quite vulnerable - where vaccination rates really fell a lot during COVID, and there are quite a few countries where 1 in 3 kids have not received any medical vaccines. And some of those countries with high numbers of unvaccinated kids are countries where there's quite a lot of travel between Australia and those countries, including India, Pakistan, Indonesia and the Philippines.”
In Australia, the joint measles-mumps-rubella vaccine is given in two doses, and is free to anyone born after 1966.
That's because people born before 1966 are understood to have natural immunity, through childhood exposure before the vaccine was developed.
The success of that vaccination program, Dr Gibney explains, led to the World Health Organisation declaring Australia "measles-free" in 2014.
“Meaning that we don't have ongoing transmission and we've maintained that, we've maintained up to now - although there's a little bit of concern currently - vaccination rates that are high enough to be sure that we'll continue to be measles-free. But if vaccine rates fall, then that is at risk. And it has happened in other countries like the UK where they received this W-H-O elimination status but then it was revoked because their vaccine rates fell, and they began to see measles transmission continuing in the UK.”
Dr Gibney says vaccination rates in Australia are still high but have been "drifting down" - and that trend needs to be reversed.
She says there's not much data available to assess whether there are any differences in vaccination among people from culturally and linguistically diverse backgrounds.
“But we know from COVID that there is the risk that people in these communities are left behind, in terms of not getting the information they need to have confidence in the vaccines available.”
And this is of concern, Dr Gibney says, because it tends to lead to lower vaccination rates, and therefore higher infection for those people.
Dr Nicole Higgins is the President of the Royal Australian College of General Practitioners.
She says it's imperative everyone makes sure they've had both doses - and explains what to do if you're not sure about your vaccination status.
“In Australia we do have a record, and previously that's been in a book, and so some parents will have recorded that. We can also check people's immunity through a blood test as well.”
Dr Higgins recommends that people unsure about their vaccination history - or worried that they're showing symptoms - should visit their G-P.
But, if you think you have measles, she warns it's important to ring ahead, so that the G-P can take precautions at the clinic to avoid spreading this incredibly contagious disease.
