Measles

Notes for Figure 2a-f:

• Excludes measles immunoglobulin administered as post-exposure prophylaxis
• Includes null doses administered to children < 12 months of age

About measles

Measles is an extremely contagious disease that is spread easily through the air. The best protection against measles is to ensure you are up to date with your immunizations.

Measles cases are increasing globally, with numerous countries and travel destinations reporting outbreaks including Canada, the United States and Europe.

Measles is a virus that spreads easily through the air when an infected person breathes, coughs or sneezes. Measles is sometimes called rubeola or red measles.

Measles symptoms include:

• a fever
• a cough
• a runny nose
• red eyes
• a blotchy, red rash that appears 3 to 7 days after the fever starts. In darker skin colours, the redness may be harder to see or may appear purple or darker than surrounding skin. It typically begins behind the ears and on the face and spreading down to the body and to the arms and legs.

Measles can be dangerous because:

• 1 in 10 people with measles will get middle ear or lung infections
• 1 in 1,000 people with measles will get encephalitis (swelling of the brain), which can lead to seizures, deafness, or brain damage
• 1 to 3 of every 1,000 people with measles will die

Who is most at risk

You are at risk of being in contact with measles if you are exposed to an infected person, or if you travel to areas within or outside of Canada where measles is spreading. If you have not had confirmed measles in the past or if you have not been fully immunized against it and you come into contact with the virus, you are at risk of getting measles. Over 90% of people who are not immune to measles and who come into contact with the virus will become infected.

Those at highest risk of severe complications from measles include:

• children less than 5 years of age
• people with weakened immune systems
• people who are pregnant

How measles spreads

Measles is an extremely contagious disease, spread easily through the air.

You do not need to be in direct contact with someone who is infected. You can get measles just by passing through a room or location where a person who is infected was up to 2 hours before. The person who is infected does not still need to be there to put you at risk of disease.

Measles can also be spread through coughing, sneezing, yelling, singing and breathing.

If you have measles, you can spread the disease before you show any symptoms. Measles can spread starting 4 days before the rash appears until 4 days after the rash appears.

• To learn more about measles disease, read the Measles disease information sheet.

Who is protected

Children in Alberta typically receive their first dose of measles containing vaccine at 12 months of age, and their second dose at 18 months of age. Children who received 2 doses of vaccine are considered protected.

Adults born in 1970 or later with a documented history of 2 life-time doses of measles containing vaccine spaced at least 4 weeks apart, or those who have a history of lab confirmed disease or serological evidence of measles immunity are considered protected.

Adults born before 1970 are generally considered immune to measles, as measles circulated widely before 1970. One or 2 doses of the vaccine may be recommended if you are a healthcare worker, student at a post-secondary educational institution or are traveling to areas within or outside of Canada where measles is spreading.

Prevention of measles

Immunization information

Further outbreaks are preventable. The measles vaccine is highly effective at preventing infection and complications from disease. Albertans can protect themselves, their loved ones and people around them by ensuring their measles immunizations are up-to-date.

Albertans can check their immunization records to confirm they have received the recommended doses of the measles-containing vaccine.

Alberta’s measles-containing vaccine eligibility is outlined in the table below. If you are traveling outside of your city or the province, see the table under the Travel advice section.

Table 6. Age and vaccine recommendation within Alberta

The measles vaccine is highly effective at preventing infection and complications. It has a long-proven track record of safety. After just one dose of measles-containing vaccine, protection is about 85% to 95% for measles, and after 2 doses, protection is almost 100%. Learn more about effectiveness, safety and side effects.

Measles containing vaccines are provided free of charge for eligible populations. To see if you are eligible to get the vaccine, you can call the Immunization Booking Line at 811 between 8 a.m. and 6 p.m. if you live in the Calgary or Edmonton Zone. If you live in another zone in Alberta, contact your local public health or community health centre.

If you have any questions about measles or immunizations, contact your primary care provider such as your doctor, pharmacist, midwife, nurse practitioner, or public health nurse.

If you do not know you or your child’s immunization history, text "vaccine record" to 88111, call Health Link at 811, or call your local public health or community health centre for assistance.

• Albertans 14 years of age and older can check their immunization history using myhealthrecords.

Routine childhood and school immunization coverage in Alberta can be found on the Interactive Health Data Application (IHDA) and visualized on the Alberta childhood immunization coverage dashboard.

Prevent the spread

There are things you can do to prevent getting sick and to protect others:

• Get your measles immunizations.
• Stay home when feeling sick.
• Avoid close contact with people who are sick.
• Call Health Link at 811 before visiting any hospital, clinic or healthcare provider.

If you think you have been exposed to measles

• If you think you or your child has been exposed to measles, call Health Link at 811 before visiting any healthcare provider, clinic, or hospital. The registered nurse who answers your call will guide you on the next steps.
• If you are not protected against measles and you are in contact with a measles case, you will be required to stay home for a period of time starting 5 days after the first exposure to the case to 21 days after the last exposure to the case. It is important to monitor yourself for symptoms during this time.
• If you have contact with the measles virus, are not immunized and are at risk for serious illness, you may be offered immune globulin. Immune globulin can help prevent measles or prevent you from getting seriously sick if you do get measles.
• Immune globulins give quick, short-term protection. For long-term protection, immunization is needed.
  • Learn more about immune globulin.

Public Health Follow-up of Measles Case and Contacts

Measles is a disease that must be reported to public health in Alberta. There are legislative requirements for reporting, case investigation and contact management. 

When someone gets measles, public health staff will contact them (or their parent/guardian) to ask and answer questions to prevent spread of infection to others. Public health will try to find out where the person caught measles and who else may be at risk of infection. This includes identifying people who may have been exposed, especially those who are not protected against the disease. If these people are found quickly, steps can be taken to reduce their risk of getting measles. Public health may need to speak with the person who has measles more than once to gather all the necessary information to help stop the disease from spreading.

People who are not immune to measles will be asked to stay away from public places during the time they may develop the disease. This helps protect others and prevent further spread of the illness in the community.

Travel advice

Measles can be spread over times of high travel (like spring break). If you are unimmunized and travelling or returning from travel, be aware of areas where measles is currently spreading.

If you or a loved one is traveling to any country outside of Canada or to or through the areas listed below where measles is spreading in Canada, consult table 6 for vaccine eligibility. This table will be updated as needed.

Areas where measles is currently spreading in Canada include:

Alberta

• Alberta Health Services North Zone
• Alberta Health Services Central Zone
• Alberta Health Services South Zone 

Ontario

• Southwestern Ontario region (#1 on this Ontario regional map)
• Hamilton, Halton and Brant region (#3 on this Ontario regional map)
• Huron, Perth, Waterloo and Wellington region (#4 on this Ontario regional map)

Table 7. Age and vaccine recommendation for travel

Get help

Online resources are available if you need advice on handling stressful situations:

• Help in Tough Times (Alberta Health Services)

If you need to talk to someone, call the 24-hour Mental Health Help Line:

• Phone: 1-877-303-2642