Measles
While measles has been eliminated in Canada since 1998, due to an increase in measles activity globally Canada has begun to see more travel-related cases. These cases can then spread rapidly in underimmunized communities.
What is Measles?
Measles is a highly contagious respiratory virus. Symptoms of measles include fever, a maculopapular rash, red watery eyes and cough. Due to vaccination measles has been eradicated in Canada since 1998. However, as measles remains endemic in other parts of the world imported (travel related) cases continue to be seen in Canada.
For updated surveillance data refer to:
Signs and Symptoms
Symptoms of measles include fever, a red blotchy rash, red watery eyes and cough. The incubation period is about 10 days (ranging from 7-18 days) from exposure to the onset of prodromal symptoms. The maculopapular rash, typically appears 14 days after infection but can appear as late as day 19 to 21.
Transmission
Measles is one of the most highly communicable infectious diseases. The measles virus spreads from an infected person through infectious respiratory particles through the air but it may also spread through direct contact infected nasal or throat secretions.
People with confirmed measles are infectious from 4 days before rash onset to 4 days after the appearance of the rash. Virus from an infected person can remain in the air or on surfaces for up to 2 hours after a the infected person has left the space.
Airborne precautions should be used for patients with confirmed or suspected measles. HCWs are to wear a fit-tested, seal-checked N95 (or an equivalent or higher protection) respirator when providing care to a patient with suspect or confirmed measles, regardless of the immunity/vaccination status of the HCW. Caregivers and visitors should be restricted to essential persons and should also wear respirators.
For more information on IPAC measures refer to:
- Updated infection prevention and control recommendations for Measles in healthcare settings/ Mis à jour des lignes directrices pour la prévention et le contrôle des infections de la rougeole dans les établissements de soins de santé (PHAC)
- PHAC Routine practices and additional precautions for preventing the transmission of infection in healthcare settings
- Interim IPAC Recommendations and Use of PPE for Care of Individuals with Suspect or Confirmed Measles (PHO)
Prevention and Control
Immunization is the best way to prevent measles transmission. This means receiving two doses of measles-containing vaccine (e.g., MMR vaccine) for children and most adults (born after 1970). Individuals planning to travel outside of Canada should ensure they are adequately protected through vaccination. For more information on immunization and post-expsosure prophylaxis refer to:
- Canadian Immunization Guide: Measles vaccines
- Prevention and Control of Occupational Infections in Health Care (2002, PHAC)
- CCDR - Updated NACI recommendations for measles post-exposure prophylaxis
- Update on measles-mumps-rubella-varicella vaccine and febrile seizures
- CCDR - Updated NACI recommendations for measles post-exposure prophylaxis (2018)
- National Advisory Committee on Immunization recommendations for measles post-exposure prophylaxis
- Update on measles-mumps-rubella-varicella vaccine and febrile seizures (2016)
Resources
- Five things to know about measles (CMAJ)
- Updated infection prevention and control recommendations for Measles in healthcare settings/ Mis à jour des lignes directrices pour la prévention et le contrôle des infections de la rougeole dans les établissements de soins de santé (PHAC)
- Measles: For health professionals (PHAC)
- Measles and Rubella Weekly Monitoring Reports (PHAC)
- Immunize Canada Resources: Poster, Myth busing, Fact Sheet, Pocket Guide for Immunizers (en français)
- Statement from the Chief Public Health Officer of Canada Update on Measles and Risk to Canadians
- Global Measles Outbreaks (CDC)
- Measles (PHO)
- Enhanced Epidemiological Summary (PHO)
- Measles: Information for Health Care Providers (PHO)
- Interim IPAC Recommendations and Use of PPE for Care of Individuals with Suspect or Confirmed Measles (PHO)
- Measles (BC CDC)
- Measles (Government of Quebec)
- Measles Outbreak (Government of Quebec)
- Measles (Saskatchewan)