Challenges in managing a school‐based measles outbreak in Melbourne, Australia, 2014

Abstract

Objective:To identify barriers to control of a Victorian primary school‐based measles outbreak. Methods:Confirmed measles cases notified in Victoria in 2014 were reviewed. Surveillance data, correspondence, and investigation notes for the school‐based outbreak were assessed regarding timeliness of diagnosis and notification, and adequacy of school‐based immunisation records. Results:Twenty‐three (31%) of the 75 measles cases notified in 2014 were school‐aged (5–18 years); three had documentation of measles vaccination, 17 were unvaccinated, and three had unknown vaccination history. Eight measles outbreaks were identified, including a primary school‐based outbreak with ten cases. Of the six unvaccinated pupils in the affected school, five (83%) contracted measles. The proportion of the school's prep students with documented vaccination records, as required by law, ranged from 39% in 2013 to 97% in 2014. Conclusions:Inadequately vaccinated students constitute a vulnerable population and schools are a potential site for measles outbreaks. Inadequate enforcement of school‐based immunisation records impact the management and control of school‐based measles outbreaks. Implications for Public Health:There is a need to educate clinicians on measles diagnosis and notification, and schools on the requirement to maintain up‐to‐date vaccination records. School entry is an opportunity to review student vaccination history and offer immunisations.