What is measles?
Measles is a highly contagious respiratory virus that poses significant health risks, and usually lasts about two weeks. Complications from measles are more likely in people who are pregnant, people who are immunocompromised, and in children less than 5 years of age.
Common complications of measles include ear infections and pneumonia, occurring in 1 of every 10 cases. Less commonly, measles can cause severe complications such as encephalitis, an infection of the brain, occurring in 1 of every 1,000 cases.
Measles causes death in about 1 to 3 out of every 1,000 cases. Before measles vaccine was widely used, almost all children got measles, and it caused over 2 million deaths worldwide, each year. Now, because of routine vaccination, very few children get measles in Canada. However, there has been a dramatic rise in measles cases globally, with recent cases identified in Ontario.
What are the symptoms of measles?
Symptoms of measles include:
- Fever
- Cough and runny nose
- Red and irritated eyes
- A red, blotchy rash that starts on the face then spreads down the body, arms and legs
- White spots may appear inside the mouth and throat 2-3 days after symptom onset
How is measles spread?
Measles virus is airborne and spreads very easily from person to person. It is passed from an infected person to others through coughing, sneezing and even talking. It can stay in the air up to two hours after someone with measles has left the room.
Once you come into contact with measles, it takes on average about 14 days for the rash to develop, but may take as long as 21 days. A person with measles can spread infection from four days before the onset of rash, to four days after onset (a total of nine days), and longer in immunocompromised people.
How can we protect ourselves?
The Measles, Mumps, and Rubella (MMR) vaccine is the most effective way to prevent the virus. vaccine. The MMR vaccine is part of the routine vaccinations in Ontario. The first dose of MMR vaccine is given at 12 months of age and a second dose is given at 4-6 years of age in the measles, mumps, rubella and varicella (MMRV) vaccine. The MMR vaccine is publicly funded and available at your health-care provider’s office or through South East Health Unit’s immunization clinics. SEHU is offering vaccine clinics for those whose vaccines are not up to date. Appointments can be booked through your health-care provider, or at hpePublicHealth.ca/clinic/immunization-clinic.
All adults born in or after 1970 in Ontario can receive two doses of MMR vaccine. All adults born before 1970 can receive one dose of MMR vaccine. In general, adults born before 1970 are likely protected from childhood infection with measles. However, unimmunized adults born before 1970 that are likely to be exposed to measles (ie. travel outside of Canada) should receive a dose of MMR vaccine for extra protection. Workers in health care, child care, school, or post-secondary and military settings are strongly encouraged to have two doses of measles-containing vaccine or evidence of immunity.
People traveling outside of Canada should ensure they are adequately protected prior to travelling. Infants aged 6-11 months may receive one dose of MMR vaccine if travelling outside of Canada (note: two additional doses of measles-containing vaccine must be administered after 12 months old to ensure long lasting immunity).
How can I protect my children?
SEHU is urging individuals and families to ensure they are up to date with their measles vaccines and to remain watchful for symptoms, especially if not fully vaccinated. Up-to-date vaccination is the best way to protect yourself and your loved ones, and prevent the spread of measles in our community.
Knowing your immunization status and being fully vaccinated for measles not only protects you from becoming ill but also prevents exclusion from school or child care if you are exposed. Parents/caregivers can update their student’s immunization record online (www.hpepublichealth.ca/immunization-reporting-records), by email at CDCIMM@hpeph.ca, or by calling 613-966-5500 or 1‑800‑267-2803, ext. 221.
What happens if I have been exposed to measles?
Depending on immunization or immunity status, individuals could be excluded from school and childcare for up to 21 days after their last exposure to measles. Exclusion is an important way to protect individuals from infection and slow the spread of illness within schools; protecting the community, including those that are not fully immunized or cannot be vaccinated for medical reasons. Exclusion means individuals are not allowed to attend school or childcare, but do not have to fully isolate at home unless they have symptoms.
Due to the high effectiveness of the measles vaccine, most people who have received two doses of the MMR vaccine, are considered immune, and would not be excluded from school or childcare. It is generally assumed that adults born before 1970 were infected as children and have acquired natural immunity to measles.
What should I do if I think I have measles?
If you suspect that you have measles, self-isolate from all public places and contact a health care provider. Call ahead and let the health care provider know you are coming and that you suspect measles, so the health care provider can take precautions in their office to avoid spread of the virus. Other viruses can cause symptoms that are similar to measles. The health care provider can order tests to confirm the diagnosis through blood, nasopharyngeal, throat and/or urine samples.
Is there a treatment for measles?
There is no treatment for measles other than supportive care. Unimmunized persons more than 12 months of age, or persons who have received only one dose of measles-containing vaccine and who have been exposed to measles, may be protected if they receive a dose of the measles, mumps, rubella (MMR) vaccine within 72 hours from exposure.
Is the MMR vaccine safe?
Yes, the MMR vaccine is safe and effective. Most children will have no reaction. MMR vaccine can cause a rash or fever in some children five to 12 days after the needle. This may last for a few days. Occasionally, a high fever can cause a convulsion. The convulsion comes from the high fever caused by the vaccine rather than the vaccine itself. Allergic reactions to the MMR vaccine are very rare.
People who have serious problems with their immune system are recommended to consult their health care provider as they may not be able to receive measles-containing vaccines. Pregnant people should not receive the MMR vaccine and people should not become pregnant within one month after getting the vaccine. The vaccine is safe for household members of people with serious immune system problems and household members of pregnant women. Breastfeeding women can receive the MMR vaccine.
Where can I get the MMR vaccine?
The MMR vaccine is publicly funded and available at your health care provider’s office. If you do not have a health care provider, you may book an appointment at Public Health https://www.hpepublichealth.ca/clinic/immunization-clinic/
Other Questions?
Talk to your health care provider or call our Infectious & Communicable Diseases Program at 613-966- 5500, ext. 349. Toll Free 1-800-267-2803 | TTY Dial 711 (1-800-267-6511)
References
- Heymann DL, editor. Control of communicable diseases manual. 21st ed. Washington, DC: American Public Health Association; 2021.
- Public Health Agency of Canada; National Advisory Committee on Immunization; Committee to Advise on Tropical Medicine and Travel. Measles vaccines: Canadian immunization guide [Internet]. Evergreen ed. Ottawa, ON: Government of Canada; 2020 Sep; [cited 2024 Mar 7]. Available from: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part4-active-vaccines/page-12-measles-vaccine.html
- Public Health Agency of Canada; Measles: For health professionals [Internet]. Ottawa, ON: Government of Canada; 2024 Feb 27 [cited 2024 Mar 7]. Available from: https://www.canada.ca/en/publichealth/services/diseases/measles/health-professionals-measles.html
- Ontario. Ministry of Health and Long-Term Care. Ontario’s publicly funded immunization schedules – June 2022 [Internet]. Toronto, ON: Queen’s Printer for Ontario; 2022 [cited 2024 Mar 7]. Available from: https://www.ontario.ca/files/2024-01/moh-publicly-funded-immunization-schedule-short-en2024-01-23.pdf
