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Measles: your questions answered

Canada achieved measles elimination in 1998, yet thus far in 2019 a whopping seventy cases of measles have been reported in Canada. Confirmed cases of measles have been reported in Québec, British Columbia, the Northwest Territories, Ontario, Alberta, and New Brunswick.1 So why are we hearing about measles outbreaks everywhere we turn? These are largely caused by imported cases of measles which have spread to susceptible individuals due to inadequate immunization.


The current measles outbreak is impacting countries around the globe. In Africa, large outbreaks of over a thousand cases are currently ongoing in: Angola, Chad, Democratic Republic of Congo, Madagascar, Mauritius and Nigeria. Similar large measles outbreaks are occurring in Europe in countries including: Albania, France, Georgia, Italy, Romania, Russia, Serbia, and Ukraine. Venezuela is experiencing a massive outbreak with over 6,200 confirmed cases reported since June 2017. In Brazil more than 10,300 confirmed cases have been reported since the outbreak began in 2018. In Israel the measles outbreak is ongoing with over 3,400 confirmed cases reported between March 2018 and January 2019. In the Philippines in January 2019, over 4,300 cases of measles have been reported resulting in multiple deaths. Japan reported over 190 confirmed cases of measles between January and the end of February 2019.2



If you think you or your child may have been exposed to measles, communicate instantly with a healthcare professional with Medisys On-Demand.

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The measles virus does not naturally circulate in Canada; however, cases have been reported in travellers to Canada from countries where measles infection is more common. An infected traveller can spread measles to unvaccinated individuals causing an outbreak here at home, in Canada.



Measles is one of the most highly communicable infectious diseases with greater than 90% probability of being transmitted to susceptible individuals. The virus is transmitted primarily through nasal or throat secretions: however; it can also be transmitted through the airborne route. The measles virus can survive at least two hours in droplets on environmental surfaces and in the air which means susceptible individuals can be infected by the virus even when the infected person is no longer present, for example, a traveller passing through an airport.



The incubation period is about 10 days (ranging from 7 to 18 days). Initial symptoms include; fever, cough runny nose, red eyes, and irritability. Small, white spots may appear inside the mouth and throat. About 3 to 7 days after symptoms begin a red blotchy rash develops on the face and spreads down the body. This rash can last 4 to 7 days. Infected individuals are infectious from up to 4 days before the rash to 4 days after the rash which means an infected individual is spreading the measles virus before he/she even knows they have it.



There is no treatment for measles. When measles complications occur, they can include ear infections, pneumonia, and encephalitis or inflammation of the brain which can result in permanent brain damage or death. Measles kills between one and three of every 1,000 infected children.



Prevention is through vaccination. Two doses of MMR vaccine provide 97% protection against measles; one dose provides 93% protection. Once an individual is vaccinated they have lifelong immunity to the disease.



In 1963, a live vaccine was approved for use in Canada. A single dose schedule with the live vaccine was introduced into all provincial and territorial routine immunization programs by the early 1970s. The routine 1-dose measles-mumpsrubella vaccine was introduced in 1983. In 1996 to 1997 every Canadian province and territory added a second dose of measles-containing vaccine to its routine immunization schedule. As well in 1996 most provinces and territories conducted catch-up programs in school-aged children with measles or measles and rubella vaccine. The following is recommended when travelling outside of Canada:


• Travellers born BEFORE 1970:
- should make sure that they have received 1 dose of the vaccine; or
- have laboratory evidence of immunity (e.g. through blood testing); or are considered immune due to a history of laboratory-confirmed measles disease

• Travellers born in 1970 or AFTER:
- should make sure that they have received 2 doses of the measles vaccine

• Infants (6 months to 12 months of age):
- routinely receive the vaccine between 12 and 15 months. During outbreaks, if you are travelling to regions where measles is a concern, it may be given as early as 6 months of age. If this is the case, the routine 2 dose series must be restarted on or after the first birthday. A total of 3 doses are given.2


If you are not sure whether or not you have had the measles infection or the measles vaccine you can get a blood test to check your immunity at your local Medisys clinic. Click here to learn more.