Ballina residents are being urged to watch for symptoms of measles after an infectious person visited a local horse riding facility at the weekend.

NSW Health has listed Equikids Horse Riding on Tamarind Drive, Ballina, as a measles exposure location between 9am and 10.30am on Saturday, September 19.

The person, who had recently returned from Southeast Asia, also visited seven other locations across the Northern Rivers while unknowingly infectious.

Northern NSW Local Health District says there is no ongoing risk at any of the locations, but anyone who was there at the listed times should monitor for symptoms for 18 days after exposure.

The alert comes as NSW has recorded 55 confirmed measles cases since January 1.

It is of particular concern on the North Coast, which has some of the lowest childhood vaccination rates in Australia.

Healthy North Coast says Northern NSW has the lowest childhood immunisation coverage of any region in the country, with vaccine hesitancy among the factors contributing to under-vaccination, along with access difficulties, workforce shortages and lower engagement with health services.

The problem is particularly pronounced in neighbouring Byron Shire, where recent figures show only 67 per cent of one-year-olds, 66 per cent of two-year-olds and 73 per cent of five-year-olds are fully immunised.

Ballina’s rates are considerably higher at 92 per cent for one-year-olds, 88 per cent for two-year-olds and 94 per cent for five-year-olds.

Health authorities say at least 95 per cent two-dose measles vaccination coverage is needed to provide herd immunity and prevent ongoing transmission.

Australia’s decades-long vaccination program was so successful that endemic measles was officially declared eliminated in this country in 2014.

However, that does not mean the disease has disappeared. Cases continue to be brought into Australia by infected travellers and can spread among people who are not immune.

All exposure locations

NSW Health has identified the following locations visited by the infectious person:

Tuesday, September 15

Shearwater Steiner School, 349 Left Bank Road, Mullumbimby, 9.30am to 1pm.

Wednesday, September 16

Bush Blossom Explores, Byron Hinterland, 9am to 3pm.

Thursday, September 17

The Patch Café, 49 Burringbar Street, Mullumbimby, 9.30am to 10.35am.

Mullumbimby Library, 70-90 Station Street, Mullumbimby, 10.45am to 12.15pm.

Friday, September 18

Pottsville Tennis Club, Berkleys Lane, Pottsville, 9am to 11.30am.

Mobile Library, Philip Street Reserve, Pottsville, 11am to 12.30pm.

Saturday, September 19

Equikids Horse Riding, Tamarind Drive, Ballina, 9am to 10.30am.

Monday, September 21

Byron Central Hospital Emergency Department, Ewingsdale, 3.30pm to 8.05pm.

Regional Director for North Coast Population and Public Health Dr Valerie Delpech said people who had visited any of the locations at the listed times should monitor for symptoms.

“Symptoms to watch out for include fever, sore eyes, runny nose and a cough, usually followed three or four days later by a red, blotchy rash that spreads from the head and face to the rest of the body,” Dr Delpech said.

“It can take up to 18 days for symptoms to appear after an exposure, so it’s important for people who visited these locations to look out for symptoms for this period.”

Anyone who develops symptoms should call ahead before visiting their GP, health service or emergency department to avoid potentially exposing other patients.

People who are pregnant, have a weakened immune system or have an infant who was exposed should contact their local Public Health Unit on 1300 066 055 if it has been less than six days since exposure.

Measles is highly contagious and spreads through the air when an infectious person coughs or sneezes.

Two doses of measles vaccine provide about 99 per cent protection against the disease.

NSW Health is urging people to check their vaccination status, particularly before travelling overseas.

Anyone born during or after 1966 should ensure they have received two doses of measles vaccine. The MMR vaccine is free in NSW for people in this age group who have not already received two doses.

People unsure of their vaccination history are advised to get vaccinated, as additional doses are considered safe.