Public Health Sudbury & Districts continues a thorough investigation into recent measles infection

Additional infections and community exposures identified

Since Public Health Sudbury & Districts reported a measles infection on Tuesday, July 22, it has been investigating the source of that measles infection and identifying other transmission that has occurred in order to prevent further spread.

Through the efforts of that investigation, Public Health has identified an initial, previously undetected introduction of measles into the area 7 weeks ago. That infection is linked to the broader measles outbreak occurring throughout North America. Through following chains of transmission from that initial infection to the one reported earlier this week, Public Health has uncovered an additional 39 measles infections in its service area. The majority of these infections have now resolved.

Public Health has identified numerous private gatherings and interactions that have led to infection spreading to these individuals. In addition, Public Health has identified some recent public locations where members of the general public may have been exposed to measles. These are listed below. Public Health is continuing its investigation by contacting individuals who were previously ill or who have been exposed to persons infected with measles.

“Over 95% of measles infections in Ontario have not been fully vaccinated; the overwhelming majority of infections we are seeing locally align with that trend,” said Dr. M. Mustafa Hirji, Acting Medical Officer of Health for Public Health Sudbury & Districts. “Since measles can cause severe illness, disability, or even death in some people, I encourage everyone to ensure they have had two doses of the measles, mumps, and rubella vaccine,” said Dr. Hirji.

Important instructions:

1. Review the locations, dates, and times below to determine if you may have been exposed to measles.
2. Check your immunization records.
3. Learn whether to contact your health care provider or Public Health.
4. Monitor for symptoms.

Step 1. Review the exposure locations, dates, and times

The measles virus can spread through the air or direct contact with an infected person. The virus can live for up to 2 hours in the air or on surfaces.

Recent exposure locations:

• Chi-Cheemaun ferry
  • Thursday, July 17: South Baymouth to Tobermory, 11 a.m. departure, AND Tobermory to South Baymouth, 1:15 p.m. departure. Monitor for symptoms until Thursday, August 7.
  • Monday, July 21: Tobermory to South Baymouth, 1:15 p.m. departure, AND South Baymouth to Tobermory, 3:30 p.m. departure. Monitor for symptoms until Monday, August 11.

Older exposures

People who were exposed on the dates listed below would have already developed illness if they were infected. Follow up with your health care provider if you have any questions or were previously ill with symptoms that could have been measles (as outlined below).

• Chi-Cheemaun ferry
  • Tuesday, June 24: South Baymouth to Tobermory, 11 a.m. departure, AND Tobermory to South Baymouth, 1:15 p.m. departure.
  • Thursday, June 26: Tobermory to South Baymouth, 1:15 p.m. departure, AND South Baymouth to Tobermory, 3:30 p.m. departure.
  • Friday, June 27: Tobermory to South Baymouth, 1:15 p.m. departure, AND South Baymouth to Tobermory, 3:30 p.m. departure.
  • Saturday, June 28: South Baymouth to Tobermory, 11 a.m. departure, AND Tobermory to South Baymouth, 1:15 p.m. departure.
  • Monday, June 30: Tobermory to South Baymouth, 8:45 a.m. departure, AND South Baymouth to Tobermory, 11 a.m. departure.
• Manitoulin Health Centre, Mindemoya, emergency department
  • Thursday, June 5, 10:15 a.m. to 12:45 p.m.
  • Saturday, June 7, 2:19 p.m. to 7:30 p.m.
  • Friday, June 27, 9:45 p.m. to Saturday, June 28, 1:30 a.m.

Step 2: Learn how to check your immunization records

If you were exposed, are fully vaccinated, and DO NOT fit into any of the groups of people listed in Step 3 (below), monitor yourself for symptoms for 21 days past your exposure.

• Check your or your family’s immunization records (online or hard copy) to confirm if you’re fully vaccinated against measles. Contact your health care provider if you are unsure.
• If you submitted your child’s immunization records to Public Health Sudbury & Districts, you can view them online using Immunization Connect Ontario (ICON) by visiting sdhu.icon.ehealthontario.ca. Public Health keeps records for vaccinations people received while under the age of 18.
• Public Health does not keep new records for those 18 and older. Check your yellow card for your vaccination history.
• If you were born before 1970, you are likely immune to measles, but consult your health care provider if you’re uncertain.
• You can find information about Ontario’s routine immunization schedule online at www.ontario.ca/page/ontarios-routine-immunization-schedule (Government of Ontario).

Step 3: If you were exposed to measles, learn when to contact your health care provider or Public Health

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.

Step 4: Monitor for symptoms

Monitor yourself for symptoms for 21 days past the date of your last exposure.

• Symptoms of measles can appear between 7 and 21 days after being exposed. Symptoms can include fever, runny nose, cough, red and watery eyes, small white spots in the mouth and throat (Koplik’s spots), and a red rash that starts on the face and spreads down the body (appears 3 to 7 days after other symptoms).

If you develop symptoms:

• Immediately isolate yourself. Stay home and avoid all contact with people who are not immunized.
• Seek testing. Call your health care provider or the walk-in clinic’s office before going so they can give you instructions to follow to protect other people, such as wearing a medical or N95 mask.
• You can also call or chat online with a registered nurse to get free, secure, and confidential health advice (24 hours a day, 7 days a week) by contacting Health811 (Ontario Government)—visit health811.ontario.ca or dial 811 (TTY 1.866.797.0007).

Vaccination remains the best protection against measles—it’s safe and effective. Measles can lead to serious complications such as lung infections, swelling of the brain, seizures, and middle ear infections, and in rare cases, death.

Public Health Ontario posts detailed information about measles cases in Ontario in a weekly summary. For more information about measles, immunization, or exposures, please visit phsd.ca or call Public Health Sudbury & Districts at 705.522.9200 (toll-free 1.866.522.9200).