Measles Alert – Increased risk of measles in NSW

NSW Health has issued an urgent clinician alert following an increase in measles cases, including two recent notifications with no known source and multiple public exposure sites across Sydney. CESPHN encourages all primary care providers to review the latest guidance and maintain a high level of vigilance.

Key points for primary care

• There is an increased local risk of measles in NSW, with 27 cases reported from 1 December 2025 to 22 February 2026.
• NSW Health notes that “most cases were adults (32–59 yrs) who were under‑vaccinated or have no proof of vaccination.”
• Consider measles in any symptomatic patient, regardless of age, vaccination status, or travel history.
• People with measles have attended emergency departments, urgent care clinics, and public transport, and exposed individuals may now be developing symptoms.

Clinical presentation

Measles may present with:

• A prodrome of fever, cough, coryza, and conjunctivitis
• A maculopapular rash beginning on the face and neck, spreading downwards
• Gastrointestinal symptoms, reported in 32% of recent NSW cases (“nausea, vomiting, and abdominal pain”)
• Atypical or milder illness in previously vaccinated individuals
• Incubation period up to 18 days (average 10 days)

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

Management of suspected cases

NSW Health advises clinicians to:

• Isolate immediately -provide a surgical mask and separate the patient from others
• Notify the Public Health Unit urgently on 1300 066 055 (do not wait for results)
• Test urgently with:
  • Nose and throat swab (PCR)
  • First‑pass urine (PCR)
  • Blood for measles IgM and IgG
• Ensure airborne precautions and mark all tests as URGENT

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.
• Individuals born 1966–1994 may be under‑vaccinated.
• Children travelling overseas may receive an early dose from 6 months (dose zero), followed by routine doses at 12 and 18 months.

Current situation

From 1 December 2025 to 22 February 2026, NSW has reported 27 measles cases, including overseas‑acquired and locally acquired infections. Ongoing outbreaks continue internationally, and recent exposures have occurred in NSW primary care and urgent care settings.

Resources, exposure locations, and alerts page

• Measles is About English language poster for practices to display at their waiting rooms. We are also working on updating a multi-language poster.
• Other measles resources can be accessed here: Measles resources and latest exposure locations here: Measles public exposure locations in NSW
• For latest NSW Health infectious diseases alerts and updates, please see Infectious diseases alerts and updates.

Read the full NSW Health Clinician Alert