"Please be aware of the symptoms, as the condition is highly contagious and we would like to minimise the effect within our community," he wrote. It comes after the Department of Health warned of more cases to come. It revealed there were now 14 cases of measles in Melbourne, including two children who attend Princes Hill Primary School where 21 unvaccinated children have been banned from the premises. The other adults with measles have been linked to the suburbs of Brunswick, Brunswick West and Preston. A spokesman for the department of health said at least one case was linked to Melbourne's eastern suburbs. Two people have been hospitalised. The department has not said which hospitals they are in. Victoria's acting Chief Health Officer Roscoe Taylor said given measles has an incubation period of up to 18 days, new cases could still be coming through, with people remaining infectious for many days without realising it. President of the Victorian branch of the Australian Medical Association Tony Bartone said the outbreak was "a huge concern", particularly when some suburbs affected did not have 95 per cent immunisation rates - enough to create herd immunity. The most recent data from the National Health Performance Authority shows none of the suburbs identified so far have 95 per cent vaccination rates for one-year-olds and five-year-olds.

Dr Bartone said given children had been infectious in recent weeks, it was highly likely that more cases would emerge. "We know it's spread by sneezing, it's spread by respiratory droplets... it can survive on surfaces outside of the body for a couple of hours," he said. Dr Taylor said measles is a highly infectious viral disease that usually begins with common cold symptoms such as fever, sore throat, red eyes and a cough. Its characteristic rash usually begins 3-7 days after the first symptoms, generally starting on the face and then spreading to the rest of the body. "Anyone developing these symptoms is advised to ring ahead to their doctor or hospital and alert them that they have fever and a rash," said Dr Taylor. "If you know you have been in contact with a measles case, please alert your GP or hospital emergency department. The doctor or hospital will then be able to provide treatment in a way that minimises transmission."

The health department says for every 1000 children who get measles, one or two will die from it or get swelling in their brain that can cause convulsions and intellectual disability. About one in 15 children with measles get pneumonia, and about one in 10 get ear infections that put them at risk of permanent hearing loss. A spokesman for the department of health said he did not know about the Footscray primary school case, but that staff were working closely with Princes Hill Primary School to provide advice and information to parents and staff. A spokesperson for Footscray West Primary School declined to comment. Education Minister James Merlino said 21 students out of 461 at Princes Hill Primary School have not been fully immunised and will be kept home until March 1. Staff who are not immunised will also be asked to work from home. "There will be individual learning plans so the kids can work from home and the teachers as well that are excluded will be able to work remotely," Mr Merlino said.

Asked whether the state government was considering introducing "no jab no play" into primary schools, Mr Merlino said: "If we can get parents fully on board with no jab no play in regards to our kindergartens then we won't have a problem in our schools." Princes Hill Primary principal Dr Esme Capp said the two students were infectious at the school between February 4-12. The health department is working with the Department of Education and Training to provide information to schools across Victoria because it fears more cases will come to light. The outbreak is causing concern among parents in Melbourne's northern suburbs. Rhiannon Reid, a Brunswick mother with a five-week old son, said the outbreak was not only scary but "frustrating". "We live in a developed society where these kind of outbreaks shouldn't happen," she said.

"My baby is 5 weeks old so too young for the measles vaccination. It's not fair that his health is put at risk due to others poor decisions which is not based on information or evidence but fear." Another mother from Melbourne's north-west, who's daughter is also only weeks old and too young to be immunised, said she was avoiding leaving her home due to the outbreak. "It's quite worrying to hear about the outbreak, especially so close to home and when your child hasn't yet built up a strong immune system. I'll definitely be trying to limit going out as much as possible," the mother said. Dr Bartone said the only thing concerned parents of infants could do is ask people around them if they are immunised. If people are not immunised, they should be kept away from babies. Dr Taylor said the disease was now uncommon in Australia because of the widespread use of the measles vaccine. He said it was important to continue immunising children because of the risk the infection can be brought in by travellers arriving from overseas.

The department of health said the groups of people most at risk of catching measles are: Anyone who is unvaccinated;

Adults between 35 and 49 years - as many in this age group did not receive measles vaccine; and

People at any age who are have an impaired immune system, even if they have had measles or have been immunised. This includes people with diseases such as cancer, and people who are undergoing cancer treatment or are on high-dose steroids. The measles vaccine (given as a combination with other vaccines) is recommended as a two-dose schedule for children between 12 months and 4 years of age. Women aged in their 20s to 40s can get a free combined measles, mumps and rubella vaccine under the Victorian Government's initiative to ensure women of child-bearing age are protected against rubella. People aged under 20 can also get it under the federal government's current catch-up campaign.

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