Measles

The first symptoms of measles infection can appear between 7 and 21 days after being exposed to the measles virus.

First symptoms include

• fever that is equal to or over 38.3 degrees Celsius (temperature taken orally)
• cough
• runny nose
• red, watery eyes
• small white spots in the mouth and throat (Koplik spots)
• 3 to 7 days after the other symptoms start, a rash appears

Rash appearance

Three (3) to 7 days after the first symptoms start, a rash will appear on the face that is red, blotchy, and is not itchy. The rash will spread from the hairline/face to the neck, waist, arms, legs, and feet. The rash can last 4 to 7 days.

What to do if you think you have symptoms

Immediately isolate yourself and avoid all contact with people who are not immunized. Seek testing but call your health care provider or the walk-in clinic before going so they can give you instructions to follow to protect other people, such as wearing a medical or N95 mask.

The measles virus spreads easily from person to person in the air or through direct contact (see below). Someone who is infected can spread the virus as early as one day before their symptoms start and up to 4 days after their rash appears. This means that people could spread the virus before knowing they are infected.

Airborne exposure

Infected people breathe out very tiny drops of the virus that can stay in the air for 2 hours. Anyone else can breathe in the virus if they are in the same space as an infected person or if they visit that location up to 2 hours after an infected person leaves.

Direct contact

You can also get infected if virus droplets touch your eyes, nose, or mouth. An infected person can spread these droplets when they breathe, cough, sneeze, or talk, because their nasal and throat secretions contain the virus. You could also become infected if you touch a surface or an object that is contaminated with the tiny drops of virus and then touch your eyes, nose, or mouth.

Vaccination

Getting vaccinated against measles is the best protection. Ontarians can receive measles vaccine at no cost. The vaccine is safe and effective. Learn about the measles vaccine and the routine schedule.

If you were born before 1970, you are likely immune to measles due to prior infection, but if you are unsure, talk to your health care provider about getting vaccinated.

There is no specific treatment for measles.

You can learn how to treat mild symptoms at home. You can also call or chat online with a registered nurse day or night for free, secure, and confidential health advice by contacting Health811 (Ontario Government)—visit health811.ontario.ca or call 811 (TTY 1.866.797.0007).

If a person has severe symptoms, they may need medical care to help prevent serious complications. If you need medical help, call your health care provider, the clinic, or hospital before going to get instructions to follow to prevent spread of the virus. In an emergency, call 911.

Common complications

• ear infections
• inflammation of the lungs (pneumonitis)
• diarrhea
• other bacterial or viral lung infections

Rare but severe complications

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

Long-term complications of encephalitis

• blindness
• deafness
• intellectual disability

Other complications later in life

Seven (7) to 10 years after having a measles infection, a person can also develop a rare brain disorder that gets worse with time. There is no cure, and the disease is fatal. This neurologic condition is called subacute sclerosing panencephalitis, and it affects the brain. The risk of this condition is higher if a person had measles before their first birthday.

• people who are immunocompromised
• children under the age of 5
• adults over the age of 20
• children who are malnourished (especially those who are vitamin A deficient)
• pregnant people who are not vaccinated and who do not have a history of measles infection

Pregnancy

If you are pregnant and become infected with measles, you could experience premature labour, a miscarriage or stillbirth, or deliver a baby with low birth weight. Talk to your health care provider if you have been exposed to measles.

Public Health alerts the community and individuals if they were potentially exposed to measles locally. When exposures occur, Public Health and health care providers work together to provide information and possibly recommend that eligible people receive vaccinations or immune globulin as soon as possible after the exposure to increase their protection from infection. Information about exposures to measles (locations, dates, times) is available through Public Health Ontario.

After a possible exposure

• Check your immunization records.
• Learn whether to contact your health care provider or Public Health.
• Monitor for symptoms.
• Tell your employer.

Learn who to contact after a potential exposure

Contact your health care provider as soon as possible to discuss vaccination if:

• Your child is 6 to 12 months of age and it has been LESS than 72 hours since they were exposed.
  • If it has been MORE than 72 hours but LESS than 6 days since your child’s exposure OR if your child is LESS than 6 months of age, contact Public Health.
• Your child is 12 months to 17 years of age and LESS than 6 days have passed since the date and time of their exposure, AND they have not received 2 doses of measles vaccine.
• You are over 18 years of age and less than 6 days have passed since the date and time of your exposure, AND you have not received any doses of measles vaccine (two doses are recommended).
  • Note: If you were born before 1970, you are likely immune to measles due to past infection, but if you are unsure, talk to your health care provider about getting vaccinated.
• You work in health care or military or are a post-secondary student and have not received 2 doses of measles vaccine (regardless of year of birth).
• NOTE: If you are pregnant and HAVE received 2 doses of measles vaccine, you can contact your health care provider if you have questions.

By receiving a vaccine soon after an exposure, you can help protect yourself and your child from infection.

Contact Public Health Sudbury & Districts as soon as possible to discuss receiving immune globulin if:

• Your child is less than 6 months of age. Contact Public Health as soon as possible after their exposure and within 6 days.
• Your child is 6 to 12 months of age and MORE than 72 hours but LESS than 6 days have passed since the date and time of their exposure.
• You are immunocompromised and LESS than 6 days have passed since the date and time of your exposure (regardless of your immunization status).
• You are pregnant, have NOT received two doses of measles vaccine, and LESS than 6 days have passed since the date and time of your exposure.

If you or your child are eligible to receive immune globulin, Public Health will coordinate a request with the hospital. Immune globulin can help protect against infection.

Call Public Health at 705.522.9200, ext. 772 (toll-free 1.866.522.9200), Monday to Friday, 8:30 a.m. to 4:30 p.m., or after hours and on weekends at 705.688.4366.

Tell your employer about your exposure

If you work in a child care setting, school, post-secondary educational institution, health care setting, long-term care home, or congregate care setting, notify Occupational Health or Infection Control at the facility where you work and follow any workplace requirements and their policies.

A person who is infected with measles can spread the virus one day before their symptoms appear and up to 4 days after the rash appears.

If your child was diagnosed with measles, they must stay home and avoid child care settings, schools, and post-secondary educational institutions until 4 days after their rash appears. Follow these instructions whether your child is fully vaccinated or not.

Public Health is automatically notified when a person tests positive for measles. A public health nurse contacts every person to provide additional directions. Please call Public Health as soon as possible if you have not been contacted.

A person who is infected with measles can spread the virus one day before their symptoms appear and up to 4 days after the rash appears.

Regardless of your vaccination history, if you have measles:

• Stay home and avoid all contact with people who are not immunized.
• Until four days after your rash appears, avoid going to workplaces, sporting events, health care facilities and other group settings, as well as schools and child care centres.

Public Health is automatically notified when a person tests positive for measles. A public health nurse contacts every person to provide additional directions. Please call Public Health as soon as possible if you have not been contacted.

Use our measles self-assessment tool to see if you are protected against measles and to learn what to do if you have symptoms, were exposed to the measles virus, or if you are unsure about your risks.

• https://www.surveymonkey.ca/r/measles