Measles

What is measles?

Measles is an infection that spreads very easily. The measles virus spreads through the air when an infected person breathes, coughs, or sneezes. It can survive in the air for up to two hours. Measles can be spread from four days before the rash appears until four days after the onset of the rash.

What are the symptoms of measles?

Measles usually starts with cold-like symptoms, followed by a rash a few days later. Some people may also get small spots in their mouth.

Measles symptoms include:

• A high temperature
• A runny or blocked nose
• Sneezing
• Coughing
• Red, sore, watery eyes
• Spots in the mouth. Small white spots may appear inside the cheeks and on the back of the lips after a few days. These spots usually last a few days.
• A rash usually appears a few days after the cold-like symptoms.
• The rash starts on the face and behind the ears before spreading to the rest of the body.

Most people fully recover from measles within two to three weeks. Some people can get very sick if they get measles. It can lead to ear infections, pneumonia, and — in some rare instances — brain swelling and death. Pregnant individuals can have a miscarriage or give birth prematurely.

What do I do if I have symptoms of measles?

If you have any symptoms, stay home. Measles spreads very easily to others. Call your health care provider to arrange testing. Call ahead to let them know that you have symptoms and inform them that you are a contact of someone with measles so that they can put measures in place to protect health care workers and other patients.

What do I do if I have measles?

• Stay at home and do not have any visitors. Stay home for four days after the appearance of the rash.
• If you need medical attention, call ahead to let the health care provider know that you are coming. That way they can put measures in place to protect health care workers and other patients.
• Avoid close contact with babies and anyone who is pregnant or has a weakened immune system. Measles can be very serious for these groups.
• Wash your hands often with soap and water.
• Do not share any utensils, glasses, cups, or water bottles.
• Cover coughs and sneezes with a tissue. Throw used tissues in the garbage and wash your hands.
• Make sure to rest, hydrate, manage your fever, and eat healthy foods.

What is the treatment for measles?

• There is no specific treatment for measles. People with measles usually recover on their own without requiring any medical care. Measles can be more severe for infants, pregnant people, and those with compromised immune systems. 
• Unvaccinated people over 6 months of age or people who have received only one dose of measles-containing vaccines may be protected if they receive a dose of MMR vaccine within 72 hours of being exposed to someone with measles.
• People who are at high risk such as young infants, pregnant people and immunocompromised people can receive a special type of medication called immunoglobulin within 6 days of being exposed to someone with measles. 

Should I go to work if I have been diagnosed with measles?

• You must stay home if you are diagnosed with measles. This applies to all cases, regardless of their vaccination history. Self-isolation will help to prevent further transmission of the virus.
• Measles is contagious and can spread to others four days before the rash starts through to four days after rash started (nine days in total).
• Do not go to work, places of worship, sporting events, non-urgent health care appointments, and group settings for four days after the appearance of the rash. 

What do I do if I have travelled or have been around someone who has travelled, and I develop symptoms?

If you have travelled or been around someone who has travelled, and you have developed symptoms of measles:

• stay home,
• isolate yourself from others, and
• call your health care provider to arrange testing.

What do I do if I have been in contact with someone who has measles?

Individuals who have been exposed to measles should stay home and call their health care provider or local public health unit immediately.

Can measles be prevented?

Yes. Immunization is the best way to protect yourself, your loved ones, and your community.

The vaccine is a safe and effective way to prevent measles. Vaccination can prevent severe illness and hospitalization, as well as serious and long-term complications from measles.

Being immunized not only protects the person getting the vaccine, but also helps to protect others who are unable to receive vaccination due to age, pregnancy or immunocompromised.

Am I eligible to get a measles vaccine?

Check your immunization records to make sure that you are up to date with your measles vaccine. If you are unsure if you are up to date with your measles vaccine, call your health care provider.

What are the measles immunization requirements for children attending licensed childcare facilities and schools?

Children who attend licensed childcare facilities are required to have received one dose of measles-containing vaccine on or shortly after their first birthday, and a second dose between 4-6 years of age.

Children who attend school are required to have two doses of measles-containing vaccine. The first dose must be given on or shortly after their first birthday, and the second dose given when the child is between 4-6 years of age.

What are the measles immunization requirements for child care workers and teachers?

The measles immunization requirement for child care workers and teachers are:

• Child care workers: Before starting their employment at licensed child care centres, child care workers must meet the immunization requirements set forth by the local medical officer of health as outlined in the Childcare and Early Years Act. This entails being up-to-date with the recommended immunizations or having a valid exemption.
• Teachers: There are no legal immunization requirements for teachers under the Education Act, although individual schools or school boards may have their own workplace immunization policies. 

The local medical officer of health can impose exclusion orders under the Health Protection and Promotion Act for teachers and child care employees if there is an outbreak, or an immediate risk of an outbreak of a designated disease in the school/child care at which the child attends.

What are the measles immunization requirements for health care workers?

Many health care facilities, such as hospital and long-term care homes, have an immunization policy requirement regarding health care worker and staff vaccinations. Health care workers within health care facilities may already be required to show proof of immunization or evidence of immunity for certain disease such as measles, rubella, and varicella. Individuals should speak with their employer to determine immunization requirements.

It is recommended that all health care workers receive 2 doses of MMR.

How do I check my immunization record?

1. Find your yellow card that you received from your health care provider. Check that you are up to date with your measles immunizations. A measles vaccine will appear on a record as M (Measles), MMR (Measles-Mumps-Rubella), or MMRV (Measles-Mumps-Rubella-Varicella).
2. If you can’t find your yellow card, through ICON or contact your health care provider.
3. If you or your child receive a vaccine, remember to bring your yellow card to the appointment or update your immunization record through ICON. Vaccination records can be accessed at any time, and an electronic “Yellow Card” can be generated when proof of vaccination is required. 

What should individuals do if they are unsure if they are immunized and unable to locate their immunization record?

If the immunization record cannot be found, individuals may be considered unimmunized and be started on an immunization schedule that is appropriate for their age and risk factors.

It is safe to give an additional dose of MMR vaccine to those who are already immune. Adverse effects or repeated immunization with combined measle-mumps-rubella (MMR) vaccine with or without varicella vaccine have not been demonstrated, regardless of prior disease or receipt of the vaccine. People who develop a serious reaction after administration of a specific vaccine, should be assessed by their health care provider before they receive additional doses of those vaccines. 

If I am fully immunized, do I need a “booster” dose?

The National Advisory Committee on Immunization (NACI) does not recommend re-immunization with measles-containing vaccine after age and risk appropriate vaccination. Furthermore, NACI indicates that the efficacy of a single dose of measles vaccine given at 12 or 15 months of age is estimated to be 85% to 95%. With a second, efficacy is almost 100%.

MMR and MMRV vaccines are very effective at protecting people against measles and preventing the complications caused by this disease. 

What is public health’s role?

The Porcupine Health Unit (PHU) follows up with all people who are suspected of or diagnosed with measles and their contacts. If there are cases in the Health Unit area, PHU will work with health care providers, workplaces, and school boards to limit the spread of the virus. PHU also offers routine immunization services for children and youth who live in the Health Unit area.