Q. I am hearing about more measles cases appearing in Ontario. Should I be worried?
A. You are correct that measles appears to be on the rise. We have not had to be too concerned about measles over the last few decades since it was officially eradicated in 1988 within Canada with only sporadic cases reported that were linked to travel. We can thank the high vaccination rates against measles in the 70’s and 80’s to accomplish this eradication.
The Measles, Mumps, Rubella (MMR) vaccine is a publicly funded vaccine and is routinely given to children, through their primary healthcare provider, around 12 months of age and again between the ages of 4 and 6. It has been found that receiving two doses of the MMR vaccine reaches near 100% efficacy. With such a high efficacy rate with the MMR vaccine, you might be wondering why we are seeing more cases of measles arising. Granted, there have always been a few people who are either against or hesitant towards vaccines. But since the pandemic, the rates of unvaccinated children have increased substantially.
During the pandemic, there was a delay or a complete oversight in the usual routine vaccinations of our children. Some parents might have decided to forego the routine vaccinations as they were feeling the effects of pandemic fatigue and many families never got back on track with their immunizations.
Measles is so contagious that nine out of 10 unvaccinated individuals who are exposed to it will get infected. It is easily spread through airborne droplets (via talking, coughing, sneezing) and these droplets can hang in the air for an hour afterwards. This means that anyone (most particularly an unvaccinated individual) that walks in that vicinity within that timeframe may acquire the infection. The droplets that find their way to land on a surface may be “active” for several hours. This is relevant for schools and daycares that may have unvaccinated children that often learn by touch, feel and putting objects in or to their mouth. This doesn’t mean that adults won’t get measles in this fashion but we ideally are not putting these objects in our mouths.
The signs and symptoms to be on the lookout for are:
· Cough
· Coryza (runny nose)
· Conjunctivitis (eye infection)
· Rash that often starts on the face and works its way down
· Fever
· Koplik spots (tiny white spots inside mouth)
As is the case with most communicable diseases, many people that acquire measles will fair okay and complain about the above symptoms. However, the very old, very young and those with compromised immune systems are at risk of serious complications. In fact, it is reported that 1 in 4 or 5 people that are infected with measles are hospitalized with pneumonia or encephalitis or death. Other complications that can arise are lifelong deafness, blindness or a fatal brain disorder.
If you do get sick with measles, there is no treatment for it other than supportive treatment of the symptoms itself. For example, you might take acetaminophen or ibuprofen to manage your fever or a cough suppressant to stop your cough. The best medicine, however, is prevention. The only way to prevent measles is through vaccination, unless you plan on living in a bubble for the remainder of your days.
If you were born before 1970, you more than likely have lifelong immunity from your exposure to measles. For those born after 1970, look into your vaccination records to see if you have been vaccinated with two doses of MMR vaccine. If you have not been vaccinated, or you have no way of finding out your vaccination status, we strongly consider getting vaccinated.
From Public Health Ontario, “People are considered protected if they have at least one of the following:
· Proof of vaccination with two valid doses of measles-containing vaccine (e.g. MMR vaccine)
· Blood work showing antibodies to measles
· Documentation of prior laboratory-confirmed measles infection
· Are born before 1970 (with the exception of health care workers)
All health care workers require evidence of vaccination with two valid doses of measles-containing vaccine or bloodwork suggestive of immunity (measles IgG reactive) regardless of year of birth. If you do not have any of the above, you are not protected against measles.”
If you discover you have been exposed, be on the lookout for the next 21 days for the above symptoms. If you fit into one of the above categories to be considered protected, it is highly unlikely that you will experience the illness.
If you do not fall into the above categories to be considered protected, follow the guidelines posted below from Public Health Ontario:
If you think you have been exposed and you are not protected against measles or if you are unsure about your immunization history:If you think you have been exposed and you are not protected against measles or if you are unsure about your immunization history:If you think you have been exposed and you are not protected against measles or if you are unsure about your immunization history:
· If you attend or work at a school, childcare, or healthcare setting, you MUST stay home and contact your local public health unit for further direction.
· If you have had no doses of MMR vaccine, stay at home and contact your local public health unit for further direction.
· If you have had one dose of MMR vaccine, call your healthcare provider or local public health unit to receive an additional dose of MMR vaccine. Notify your healthcare provider of your exposure so that they can take appropriate precautions to limit the spread of measles.
Unless you work in a healthcare setting, you can immediately return to work, school, or daycare after you get a second dose of measles-containing vaccine.
· If you (or a family member) are at high risk of complications as listed below, contact your healthcare provider or local public health unit to discuss options to reduce the risk of measles infection through vaccination or a product called immunoglobulin. For these to be effective, they must be given very soon after exposure.
- Babies under one year age who have not received measles vaccine
- People with a severely weakened immune system
- Pregnant individuals who are not protected against measles
· If you are uncertain about your vaccination status, call your healthcare provider or your local public health unit to determine if you have received an MMR vaccine in the past.
· Watch for the onset of measles symptoms until 21 days after the date of exposure (see Places and dates of possible exposure to a case of measles).
- If you develop symptoms and need medical care, call ahead before you visit the doctor, clinic, or hospital to inform them of your exposure to measles so they can prepare for your arrival and take appropriate precautions. o If you develop symptoms and do not need medical care, call your local public health unit.
If you develop symptoms and need medical care, call ahead before you visit the doctor, clinic, or hospital to inform them of your exposure to measles so they can prepare for your arrival and take appropriate precautions.
If you develop symptoms and do not need medical care, call your local public health unit.
For more information on this or any other health related topic, contact your pharmacist.
