Measles

Measles (red measles or rubeola) is a disease caused by the measles virus. It is not the same as Rubella (German measles). There has been a large decrease in the number of measles infection in countries where vaccines are widely used. However, measles remains a common disease in many parts of the world.

Measles is diagnosed by a history of contact with someone who has the disease, symptoms and laboratory testing. A blood test and samples from the nose, throat and urine should be collected to confirm the diagnosis. While waiting for measles test results, self isolate at home. Avoid contact with other household members, and wear a well-fitting mask, if possible. Do not go to daycare, school, work or any other social settings until measles has been ruled out. 

If the test result is positive, continue to self-isolate at home. Public Health will contact you to provide further information about preventing transmission to others. 

Symptoms usually start about eight to 12 days after exposure and include: high fever, runny nose, cough, sore eyes and tiny white spots on the inside of the mouth. Following these symptoms, a red blotchy rash appears on the face and then on the rest of the body. Most people are sick for up to 10 days and then recover completely.

Measles can also cause ear infections or pneumonia (a serious infection of the lung). Sometimes measles can lead to swelling of the brain (encephalitis) which can cause seizures, deafness, brain damage or death.

If measles is suspected, self isolate. Call 811 and follow their instructions for testing or care. Do not go to a health-care facility or office without calling ahead first.

Measles is highly contagious, and the virus can live in the nose and throat mucus of an infected person from four days before to four days after the rash develops. It can spread to others through coughing and sneezing. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses or mouths, they can become infected. 

The virus can also be spread by direct contact with infected nasal or throat secretions through: 

• kissing, sharing food, drinks or eating utensils 
• sharing toothbrushes, mouth guards, towels, cigarettes or lipstick 
• sharing mouth toys (young children) or musical instruments with a mouthpiece

Once someone has had measles, they are considered protected for life. Most individuals born before 1970 likely had measles as a child and are considered to be protected. Anyone born after 1970 who has not had two doses of measles vaccine and has never had measles is at risk. 

There is no specific treatment for measles. Symptoms such as fever and headache may be treated with medicine by following the manufacturer’s instructions. Ask your health-care provider what medicine is best.

Health-care providers, hospitals and laboratories, schools and childcare centres must immediately report cases of measles to Public Health. Public health staff will interview the health-care provider and patient (or caregivers) to find out how the infection occurred, identify other people at risk of infection, start actions to help stop the spread of the infection (such as immunization and restrictions on attending school or work) and provide other advice.

The best way to protect against measles is to be immunized. A single dose of measles vaccine is estimated to be 85% to 95%. However, with a second dose, it increases to almost 100%. 

In New Brunswick, children are routinely immunized with two doses of a combined measles, mumps, rubella and varicella vaccine (MMRV) at 12 and 18 months old. 

Children six to 11 months who are travelling domestically to areas with measles activity or internationally (i.e. any international travel, whether or not measles activity has been identified) can receive one dose of MMR vaccine. The early dose does not replace the routine childhood immunization schedule. Two doses of measles, mumps, rubella and varicella (MMRV) will still be required at 12 and 18 months. 

Individuals born in 1970 or later who have not previously received two doses of MMR vaccine should contact their health care provider to be immunized.  

Consult your primary care provider, pharmacist or local public health office travel to ensure you are up to date with your immunization. 

People with measles should not attend childcare centres, school or work for four days after the rash appears. Covering your nose and mouth when coughing or sneezing, disposing soiled tissues, washing hands well and not sharing eating utensils, food or drinking cups will also help to reduce the spread of infection. 

For additional information, contact your health-care provider, local Public Health office or Tele-Care 811.