Measles alert for clinicians – increased local risk in NSW

NSW Health has issued an urgent clinician alert following several recent public exposures and a locally acquired measles case in Sydney with no known source. CESPHN encourages all primary care providers to review the latest guidance and remain vigilant.

Key points for primary care

• There is an increased local risk of measles in NSW due to recent public exposures, and one locally acquired case with no identified source.
• Consider measles in any symptomatic patient, regardless of age, travel history, or vaccination status.
• People with measles have attended public venues, concerts, and public transport in Sydney, and exposed individuals may now be developing symptoms.
  

Clinical presentation

Measles typically presents with:

• A 2-4 day prodrome of fever, cough, coryza, and conjunctivitis
• A maculopapular rash beginning on the face and neck, spreading downwards
• Atypical or milder presentations may occur in previously vaccinated individuals

Patients are usually infectious from one day before the prodrome to four days after rash onset.

Management of suspected cases

NSW Health advises clinicians to:

• Isolate immediately – measles is highly contagious
• Notify the Public Health Unit urgently on 1300 066 055 (do not wait for test results)
• Test with urgent PCR (nose/throat swab and first-pass urine) and serology (IgM/IgG)
  

Vaccination recommendations

• Offer MMR vaccination to anyone born in or after 1966 without documented evidence of two doses
• MMR is free in NSW for eligible individuals
• Children travelling overseas may receive an early dose from 6 months of age (dose zero), followed by routine doses at 12 and 18 months
  

Current situation

As of 2025, NSW has reported 29 measles cases, including overseas-acquired, interstate-acquired, and locally linked cases. Ongoing outbreaks continue internationally and within Australia, including in WA and QLD.

Read the full NSW Health Clinician Alert