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Summary

The National Public Health Service (NPHS) is alerting primary care clinicians to an ongoing very high risk of measles throughout Aotearoa New Zealand.

There have been 45 cases of measles reported in Aotearoa since September 2025 (including the Northland outbreak). We are expecting additional cases over the summer holiday period arising from recent exposure events. The risk will also be higher over the summer months as more people will be travelling both within Aotearoa and internationally.

Healthcare settings including primary care and laboratory collection centres are considered high risk for the transmission of measles. There have been several exposure events in these settings that have generated large numbers of contacts, and further measles cases.

Key messages

  1. Healthcare settings are considered high risk for the transmission of measles — wherever possible, triage and review people with measles-like symptoms through a red stream.
  2. Test anyone presenting with compatible symptoms with a nasopharyngeal PCR swab. Do not send anyone with suspected measles to a community testing facility for any tests.
  3. Notify your local Medical Officer of Health of all suspected cases. Do not wait for test results. If there is a high index of suspicion for measles, notify immediately as per your usual local notification process (see criteria below). Please note that some local public health services require notification by phone. 
  4. Advise anyone that has been tested for measles to isolate at home until their results are known — public health will contact them if they have a positive test result. If measles is not detected, their healthcare provider should inform them and advise that they can leave isolation. 
  5. Ensure all primary care and pharmacy staff (including non-clinical and admin) have document evidence of measles immunity. Staff who are not presumed immune due to age and who don't have documented immunity will be excluded from working for an extended period if they are contacts of a measles case.
  6. Community pharmacies should advise people presenting any measles-like symptoms to go directly home and to call Healthline or their healthcare provider for advice.

Key actions for healthcare professionals

Triage

  • Minimise the risk of measles exposure in primary care by displaying measles alert messages and supplying masks at entrances and in waiting rooms. Measles alert resources are available on HealthEd.
    Measles — HealthEd (external link)
  • Wherever possible, triage and review people with measles-like symptoms (including respiratory symptoms) through a red stream. Triage anyone, including anyone arriving from overseas, with a febrile illness as potentially infectious.

Identify

  • Remain vigilant for anyone with measles symptoms, including a runny nose, fever, cough, sore watery pink eyes (conjunctivitis) and a rash that develops a few days after fever. Fever (>38°C) is still present at the time of rash onset.
  • Prioritise assessment of possible measles in anyone who was at a location of interest (including those classified as casual contacts) or has recently been overseas.
    Locations of interest (external link)
  • Note that people who have received one or two MMR vaccines or are presumed immune due to age (born and lived in Aotearoa before 1969) may present with modified and attenuated clinical symptoms compared to unvaccinated individuals.

Isolate

  • If measles is suspected, provide a medical mask, isolate the patient immediately and keep the door closed.
  • Ensure all staff who enter the room are immune to measles and wearing an appropriate mask (ideally a fitted seal checked N95/P2, but if not available, then a medical mask as a minimum).
  • After the consultation, leave the room vacant with the door closed and windows open where possible for at least one hour.
  • Advise any patients with suspected measles to go directly home and isolate without stopping on the way (for example, at a pharmacy or supermarket).
    • If the test confirms measles, public health will contact the case.
    • If measles is not detected, the person’s health provider should inform them of this negative result and release them from isolation
  • Community pharmacies should advise people presenting any measles-like symptoms to go directly home and to call Healthline or their healthcare provider for advice.

Test

  • Test all suspected cases of measles as per your local HealthPathways with a nasopharyngeal (preferred) or throat swab PCR for measles and include relevant clinical details, travel history, the date of rash onset and known measles vaccination history on the laboratory request form. If you are unsure how to collect a sample, visit HealthPathways for guidance.
    HealthPathways (external link)
  • Do not send patients to laboratory collection centres for any tests if they have any measles symptoms.
  • Inform patients they will receive a phone call from public health if their swab tests positive for measles and they will be asked about their movements, contact with others, and vaccination history.

Notify

  • Notify your local public health service team on suspicion of measles as per your usual notification process found on HealthPathways. Do not wait for test results.
    HealthPathways (external link)
  • If you have a high index of suspicion for measles (see criteria below), notify immediately as per your usual local notification process. Please note that some local public health services require notification by phone.
    Notify public health
    This is anyone who has a clinically compatible illness (see above for symptoms) and at least one of the following:
    • is not immune, partially vaccinated, or has unknown immunity to measles
    • is a known contact of a measles case or has had contact with someone with measles-like symptoms
    • was present at a measles location of interest
      Locations of interest (external link)
    • has travelled overseas or has had contact with overseas travellers.

Contact details for local public health services (external link)

Prevent

Further information

Information sheet to share with patients if you suspect measles:

Measles — Health New Zealand (external link)