Auckland Medical Officer of Health Richard Hoskins spent most of 2011 trying to stamp out measles from his community, after two separate outbreaks made more than 595 people ill in Auckland and many other parts of New Zealand.
Auckland Regional Public Health Service team members, including Dr Hoskins, worked many thousands of hours tracing the contacts of sick people to reduce the spread of the illness.
As well as finding and isolating any new cases, they were looking for any vulnerable contacts, such as children with cancer, who would be more likely to get seriously ill and need special care.
At times during the outbreaks, parents also had to be asked to keep unimmunised children at home to stop them from spreading the disease if they got sick.
So much work for something that Dr Hoskins says wouldn’t have happened if there was a higher rate of immunisation in New Zealand.
‘Our immunisation rate for babies is getting better but it’s not high enough overall and there is a whole generation of adults where it was far too low. The problem is that there are still enough people who are not immune for measles to really take hold like it did last year.
‘In the first outbreak in 2011, a child came back from the UK and went to a school where about 70 parents had elected not to immunise their children.’
Six children and one adult, all of whom had not been immunised, were infected by the first child and the outbreak was under way, with more than 30 new cases of measles in the worst week.
‘At the end of the day we have had hundreds of people who didn’t need such a significant illness and all the other things it entails – lost days at school, weeks away from work, not being able to go to the school ball . . .’ Dr Hoskins says.
‘On top of that, there are all the unimmunised children who were not able to go to school and the parents that had to stay home from work to look after them.’
While measles can be a mild to moderate illness for most people, the Auckland Regional Public Health Service team don’t regret the many hours they have spent reducing its spread.
‘Most people make a full recovery from it but not everyone does and we don’t need it wrecking even a few lives,’ Dr Hoskins said.
When he was a medical student in the 1970s and 1980s Dr Hoskins remembers visiting a psychopaedic hospital that included patients who were permanently brain damaged from measles.
‘One of our biggest problems is that as a society we don’t have a collective memory of measles. You often hear people saying, “I got measles as a kid and it didn’t hurt me,” but most of us born before 1969 had measles before we were five and don’t remember what it was like. And it’s so long ago that many of our parents don’t either.
‘No one in New Zealand has died of measles since 1991 but if outbreaks such as those in 2011 continue to occur it is only a matter of time before it happens again.’
Several people in Auckland spent relatively long periods of time in hospital in the 2011 outbreaks, with many more visiting hospitals and after-hours clinics to be checked and rehydrated.
‘All of our measles cases in recent years can be traced back overseas. The next cases will come in that way too,’ Dr Hoskins says.
‘The best thing we can do is to eliminate measles from New Zealand and the globe through immunisation, just as we did with smallpox. If anyone wasn’t vaccinated as a baby and they were born after 1969, it’s free and never too late.’
This case study was originally published in Immunisation: Making a choice for your children.