Is measles making a comeback in Australia?

In 2014, the World Health Organization (WHO) declared Australia had eliminated endemic measles.
 
While there have been outbreaks since, with the virus brought into Australia from overseas, all have been contained.
 
For a while, even those cases fell off, with strict travel restrictions imposed due to the COVID-19 pandemic.
 
In 2025, however, the highly infectious virus appears to be bouncing back to pre-pandemic levels.
 
This year, 29 cases have already been reported, compared to 57 in the entirety of 2024, 26 in 2023, seven in 2022, zero in 2021, and 25 in 2020.
 
Both Victoria and New South Wales have reported 13 cases, with several transmitted locally. There have also been isolated instances in South Australia, Western Australia and the Northern Territory.
 
In one Victorian case, transmission occurred in a waiting room.
 
This highlights ‘the importance of immediate isolation of people with fever and rash who present to healthcare settings’, according to Victorian Chief Health Officer Dr Tarun Weeramanthri.
 
It comes at the same time as public health experts are raising the alarm in the United States, where hundreds of cases have been reported across multiple states, mostly among unvaccinated people.
 
One death has been directly attributed to the virus in the US and another is currently under investigation.
 
And just last week, the WHO revealed that 127,350 measles cases were reported in the European Region for 2024, double the cases in 2023, and the highest number since 1997.
 
So, what does it mean for general practice in Australia, and is the disease likely to make a significant comeback?
 
For Dr Tim Jones, Chair of RACGP Specific Interests Child and Young Person’s Health, the outbreaks are the source of ‘increasing concern’.
 
‘We’ve seen a doubling of measles cases over the last two years in Australia,’ he told newsGP.  
 
‘They dropped to almost nothing in the pandemic, and we know that we’ve got falling vaccination rates, so this is going to be bigger in the future.’
 
While many younger GPs may never have seen a measles case, Dr Jones does not have diagnostic concerns.
 
‘I like to think that measles is one of those diseases that we learn in medical school for a reason,’ he said.
 
‘We learn it because we’re not to miss it, and so those patients with quite iconic features of measles, I hope that none of them slip through our net.’
 
Margie Danchin, a Professor of Paediatrics and vaccine expert at the Murdoch Children’s Research Institute (MCRI), described the recent outbreaks as a ‘huge concern’.
 
‘Childhood vaccination coverage rates at one, two and five years have been dropping steadily since the start of the pandemic,’ she told newsGP
 
‘And the MMR vaccine is given at 12 months and 18 months, so all kids need two doses, and that coverage has definitely slipped a couple of percentage points, which is still masking the geographic areas where it slipped a lot more.’
 
Professor Danchin says while most outbreaks are contained, she does not view Australia’s endemic measles-free status as being in immediate jeopardy, the potential for spread is increasing.
 
‘It’s not impossible, but I think we’re quite far from that in Australia at the moment,’ she said.
 
‘But there are still regions around Australia, like the Northern Rivers region in New South Wales, even in pockets of inner-city Melbourne and Sydney, where the vaccination coverage is very low.  
 
‘In the Northern Territory, amongst indigenous children, for example, the MMR coverage is below 90% so we’ve got pockets all over Australia.
 
‘And unfortunately, measles is the most infectious virus that we know. We call it a heat-seeking missile, and we know that one primary case can lead to 18 secondary cases, so if you’ve got an under-vaccinated population or community, then measles can spread very quickly.’
 
Professor Danchin says while the rise of vaccine hesitancy is well documented, feedback from the Vaccine Barriers Assessment Tool (VBAT) developed by MCRI suggests access may be more significant.
 
‘The media often frames the under-vaccinated group as hesitant or refusing, when many of these families are just struggling financially,’ she said.
 
‘They’re working, there might be single-parent families with lots of kids, and they just can’t get their kids to be vaccinated due to very understandable reasons.
 
‘And I don’t think we’re reacting to that.
 
‘If we want to really stop measles becoming a major problem in certain areas, we need to start acting around improving access.’
 
Dr Jones is familiar with the concerns.
 
‘It saddens me, I’m hearing the same message in my community that there are too many families out there who just don’t have a GP,’ he said.  
 
‘I’m really seeing those areas where access is very challenging as an opportunity for GPs collectively and practices individually to look at what they can offer their community.
 
‘They may not be able to take on every family out there that doesn’t have a GP, but to be able to proactively offer an appointment for a check-up and any catch-up vaccines that may be needed, I think there are communities within our country that are needing that.
 
‘We’re down to under 91% of our two-year-olds in Australia are now fully immunised, and we need to be 95% for herd immunity to be protecting everyone, so this is getting increasingly concerning.’
 
Dr Jones also warned of the increased likelihood of rubella in measles hotspots.
 
‘The two diseases can look very similar clinically, so if we’re thinking about one, we need to be thinking about the other at the same time,’ he said.
 
Associate Professor Anita Heywood, an infectious disease epidemiologist at the University of New South Wales School of Population Health, added that the level of air travel between other countries and Australia is another significant factor in outbreaks.
 
‘Whenever there’s been big outbreaks around the world in the areas that have high air traffic between Australia, then we tend to have quite a few cases come in,’ she told newsGP.
 
Like Dr Jones, she says the outbreaks are a reminder of the importance of vaccination when heading overseas.
 
‘Travel vaccination is really important,’ Associate Professor Heywood said.
 
‘A lot of people, GPs, might think of typhoid and [hepatitis A], but following up on routine immunisations, particularly measles, is really important as well.’
 
Professor Danchin, meanwhile, hopes the recent outbreaks act as a deterrent to complacency.
 
‘Measles is now a serious risk in our country, and parents need to take that seriously so it’s no longer that thing that happens somewhere else,’ she said.
 
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