Measles

Initial symptoms include:

• fever
• cough
• runny nose
• red, watery eyes

2 to 3 days after the start of symptoms, 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. The rash can last 4 to 7 days.

If you suspect you might have measles, call ahead prior to attending an appointment with your health care provider or walk in clinic, let them know your symptoms, and wear a mask when you attend the appointment.

Common complications include:

• ear infections
• pneumonia (lung infection)
• diarrhea

Although rare, measles can also cause severe complications such as:

• respiratory failure
• encephalitis (inflammation and swelling of the brain), which can cause seizures, brain damage or death.
• death

Long term complications of encephalitis include:

• blindness
• deafness
• intellectual disability

Subacute sclerosing panencephalitis, a neurologic condition that affects the brain, may develop 7 to 10 years after recovering from measles. The risk is higher if a person has measles before 2 years of age.

Measles infection during pregnancy can result in a high risk of premature labour, miscarriage, stillbirth, and low birth weight infants. Pregnant individuals should talk to their health care provider if they have been exposed to measles. Children with measles should be watched closely since it can lead to serious complications.

If more serious complications occur, immediately make arrangements to see a health care provider.

The measles virus spreads easily from person to person:

• When breathing air in a location where someone who’s infected is or has recently been
• Through direct contact with nasal or throat secretions from infected persons. This happens when an infected person breathes, coughs, or sneezes, or talks and the droplets enter the eyes, nose and mouth of another person.
• By touching a contaminated surface or object and then touching eyes, nose or mouth.

In Canada, exposure to measles should be taken very seriously.

People with confirmed measles are infectious from 1 day before the beginning of the prodromal period (usually about 4 days before rash onset) to 4 days after the appearance of rash. Measles usually lasts about 2 weeks. People who recover from measles have lifelong immunity to the disease.

If you think you may have measles the first step is to contact your health care provider by telephone to describe your symptoms. If your health care provider asks you to come to the clinic, ensure you wear a mask upon arrival and ask to wait in a private room if available.

There is no specific treatment for measles. The treatment is meant to relieve symptoms and to prevent severe complications.

Supportive care in hospital might be needed for severe infections.

You can treat mild symptoms at home.

The best protection against measles is vaccination. The vaccine is safe and effective. In Ontario, the measles vaccine is combined with the mumps and rubella (MMR) vaccine and may also include varicella (MMRV) vaccine. The specific vaccine provided depends on the age and vaccination history of the child. Two doses of measles-containing vaccine are required and provide lifelong protection against measles.

Ontario’s Immunization of School Pupils Act (ISPA) requires that children and adolescents attending primary or secondary school be immunized against measles, unless they have a valid exemption. Most adults born in or after 1970 require 1 dose of vaccine although 2 doses are required for health care workers, post- secondary students, and travelers regardless of their year of birth. People born prior to 1970 are generally considered to be protected from measles because they were most likely exposed as a child, with the exception of those listed above.

The spread of measles can also be prevented by washing your hands after coughing, sneezing, and going to the washroom, and before preparing foods or eating. If you do cough or sneeze, cover your nose and mouth. Follow preventive measures to reduce the spread of infection.

You are considered protected against measles infection if you are born before 1970, have had measles in the past, or have received 2 doses of measles-containing vaccine.

If you have been exposed and do not have this protection, contact Public Health Sudbury & Districts, or your health care provider as soon as possible.

If you have infants under 6 months of age, are pregnant or have a weakened immune system, you can be treated with another medication up to 6 days after exposure. Contact Public Health Sudbury & Districts or your health care provider for more information.

Health care workers are recommended to notify their employer of their potential exposure and follow any workplace requirements as per their agency policy.

If your child is diagnosed with measles, they should stay home. Avoid child care settings, schools, and post-secondary educational institutions for 4 days after the appearance of the rash. This applies regardless of your vaccination history.

If you are diagnosed with measles, you should stay home. Avoid workplaces, sporting events, health care, and other group settings; and non-household contacts for 4 after the appearance of the rash. This applies regardless of your vaccination history.

It is not necessary to have a blood test or to check your titres. You can check your immunization record with Public Health Sudbury & Districts or your health care provider if you are unsure of your vaccination status.

Before you travel, check if your destination is experiencing a measles outbreak. Measles vaccinations may not be included in standard travel vaccines, so it is a good idea to speak with a  travel clinic before your trip to see if any additional vaccines are recommended.

It is best for children to follow the measles vaccine schedule (Government of Ontario) for optimal protection. There may be situations where a child may benefit from being immunized earlier than the recommended schedule, for example prior to travelling. Speak to a health care provider about the timing of your child’s vaccines based on your child’s specific risks. If vaccinated early, additional vaccines or additional doses may be required to ensure they are up to date for their age and eligibilities.