Case study: Northern Beaches Medical Centre (2019)
One Friday afternoon, a young man walked into our consulting room. He had recently returned from a holiday in New Zealand and had presented a few days earlier with flu-like symptoms. The flu swab had come back negative and this time he was complaining of a rash and conjunctivitis. Being aware there had been a large measles outbreak in New Zealand, we knew that we had to act quickly.
We isolated the man and contacted NSW Health to notify a suspected case of measles. We closed the practice and ensured all people who had been in the waiting room, and our staff, were managed for exposure. This included checking immunisation status and offering on-the-spot immunisations to anyone not fully vaccinated. We also administered immunoglobulin to one person who could not have the live vaccine.
The whole practice underwent a clean, including the waiting room, consultation room and bathroom. Contact tracing was carried out by NSW Health for those who may have been in contact with the patient during his previous visit to the practice. Contacts were identified by extracting time stamp information from our practice management system. Fifty per cent of those contacted came back to the practice within 24 hours, where they were managed by the one allocated GP.
The man’s condition deteriorated, resulting in pneumonia. After a brief hospitalisation, we’re glad to say he made a full recovery from measles.
This case was a wake-up call for the whole practice. In these cases, you need to be proactive and work as a team to keep patients and staff safe. This case has also focused our attention on patients’ travel histories.
Dr Jonathan Adams and Dr Penny Burns