A measles outbreak that began at a international hip-hop dance competition in Sydney has spread across the country and overseas, leaving at least 14 people infected and tens of thousands of people exposed to the disease.
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The outbreak began when a Filipino man with flu-like symptoms competed at 2013 World Supremacy Battlegrounds, attended by more than 2000 people at the Sydney Olympic Park Sports Centre in Homebush on December 7 and 8.
A 10-year-old girl in Adelaide was next to fall ill. She too had been at the competition.
Then a woman in Auckland was diagnosed. And a person in Sydney. And nine more people in Turangi and Taupo in New Zealand - six of whom had not gone to the competition, but knew someone who had.
Most recently, a 21-year-old man from Melbourne fell ill, but his symptoms only emerged after he had spent Boxing Day amid the throngs of people taking advantage of Christmas sales at the city's busiest shopping centre. He too had attended the Sydney event.
A person who isn't immunised against measles can get sick by coming within three metres of an infected person.
"There is an increased risk of transmission in a busy place like [the shopping centre] Chadstone on Boxing Day," Australian Medical Association Victoria vice-president Tony Battone said. "If someone sneezed and you walked though that sneeze, then you would probably get it."
Throughout the hip-hop dance event, competitors in teams of 10 or more rehearsed together backstage. Organisers then sat all 900 performers together in the stands at Sydney Olympic Park Sports Centre to watch the other performances.
The incubation period for measles is 10 to 18 days - 22 days after the event, on December 30, New Zealand Health Authorities got in touch with the organisers to inform them of the outbreak.
Dancers from Japan, the Philippines, New Zealand, Australia and three other countries had competed at Homebush.
Organisers then had the arduous task of contacting them when the contagious illness broke out.
They finally traced it to a competitor from a Manila dance troupe, FMD Xtreme, whose management said had turned up at the competition with flu-like symptoms.
"He still performed because he came all the way from the Philippines," World Supremacy Battlegrounds event director Marco Selorio said.
"They gave him cold and flu tablets but his rashes didn't come out until December 11 - after the competition.
"It's hard to track something like this when the rashes don't break out until after the event, we just don't know."
Only three days after the event concluded, the Philippines Department of Health warned the Filipino public about a huge increase in measles cases in 2013.
The department's Regional Epidemiology Surveillance Unit published figures that showed 179 confirmed measles cases in 2013 from January 1 to December 10, a more than 600 per cent increase on the 25 cases during the same period in 2012.
Dr Vicky Sheppeard, the director of Communicable Diseases at NSW Health, said that measles was highly contagious among people who were not fully immunised.
“[It] is spread through coughing and sneezing," Dr Sheppeard said. "Symptoms can include fever, tiredness, runny nose, cough and sore red eyes which usually last for several days before a red, blotchy rash appears.
"Complications can range from an ear infection to pneumonia or swelling of the brain.”
Mr Selorio said that nothing like this had happened in the event's nine-year history but he was considering what precautions the festival could take in the future.
with Goya Dmytryshchak and Alfred Chan
