Measles alert

Immunization is key to preventing fast-spreading infection

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Winnipeg Health Region
Wave, May / June 2014

What is measles?

Measles, also known as reobela, is a viral infection that causes a rash, high fever, and cough. It is caused by the measles virus, a member of the genus Morbillivirus of the family Paramyxoviridae.

Measles can lead to a number of health problems, including sore throat, ear infection, diarrhea, or pneumonia. Sometimes, measles may lead to inflammation of the brain and seizures. Although death from measles is rare in Canada, it is one of the leading causes of vaccine-preventable deaths in children worldwide, according to Health Canada.

Are measles, roseola and rubella the same thing?

No. Measles, roseola (also called baby measles) and rubella (German measles) are all caused by different viruses and are distinctly different diseases. Roseola and rubella are often mistaken for measles.

I understand cases of measles in Canada are on the rise. Why?

Although immunization is recommended, many children get measles each year because they have not been vaccinated. A number of cases this year have been attributed to unvaccinated people becoming infected while travelling in countries where immunization rates are low, and then returning home where they then spread the virus. There have also been cases of people becoming infected locally. There have been eight laboratory-confirmed cases of measles reported in Manitoba as of May 6.

How do measles spread?

Measles is spread through the air by coughing or sneezing. It can be transmitted from four days before the rash appears to four days after. Measles usually lasts between 10 and 14 days.

Measles is highly contagious and can be spread easily through the air, or through contact with fluids from the nose or throat. The virus can pass from person to person by coughing, sneezing or sharing food or drinks.

What are the symptoms?

Symptoms occur seven to 18 days after exposure. The infected person will first get a fever that can peak as high as 39.4 to 40.6 degrees Celsius (103 to 105 degrees Fahrenheit) and last two to four days. The fever is followed by symptoms such as a dry cough, runny nose, red and swollen eyes, nasal congestion, sneezing, and white spots inside the mouth. The rash, which appears three to seven days after exposure, starts on the face, then spreads down the trunk and out to the arms and legs. The rash lasts five to six days.

How are measles treated?

There is no cure for measles. Current treatment focuses on relieving the symptoms and can include:

  • Adding moisture to the air with a vaporizer to ease symptoms. Nose drops and cough medicine may help relieve a stuffy nose and cough.
  • Giving your child plenty of fluids to drink.
  • Dimming bright lights if your child's eyes are sensitive.
  • Giving acetaminophen or ibuprofen to control fever. Children under 18 years of age should not take aspirin or products containing salicylate (such as Pepto-Bismol) because of the risk of Reye's syndrome, unless recommended by a health-care provider. Giving a sponge bath with lukewarm water may help bring down a high fever.

When should I call my child's health-care provider?

Call your health-care provider if your child becomes listless or has a high fever that lasts more than four days. Also call if the child has a severe headache, earache, or a cough that lasts four to five days with yellow or green mucous. Seek emergency medical treatment if the child has trouble breathing or has seizures.

It is important to stay home from work, school or child care as measles is highly contagious. If you need to seek medical attention, call before you go so the medical service can take the precautions needed to keep you isolated from all other clients. Keep your child away from people who have not had measles or have not had a vaccination for measles, especially pregnant women.

Can measles be prevented?

Yes. The best way to guard against measles is to get immunized. The same is true for mumps and rubella. The measles, mumps and rubella (MMR) vaccine contains weakened forms of these viruses that do not cause disease. The vaccine is approved by Health Canada. MMR is now available combined with the chicken pox vaccine (varicella), MMRV.

When you and your child are immunized, you also help protect others because someone who is immunized is less likely to spread infection.

Other precautions you can take include:

  • Avoid sharing personal items such as water bottles, lip gloss and cigarettes.
  • Cover your nose and mouth with your forearm or tissue when you cough or sneeze.
  • Wash your hands often with soap and water or clean them with alcohol-based sanitizer if soap and water are not available, especially after coughing or sneezing.

Who should get immunized?

All children 12 months of age or older should get the MMR vaccine. The vaccine is usually given to children in a series of two shots. The first shot is given between 12 and 15 months of age and the second between four and six years of age.

All adults born in 1970 or later should be immunized with one dose of MMR, unless you have:

  • Documented evidence of receiving measles-containing vaccine on or after your first birthday.
  • Laboratory evidence of immunity.
  • A history of laboratory-confirmed measles infection.

Adults born before 1970 are generally presumed to have acquired natural immunity to measles. However, some of these individuals may be susceptible to measles.

If you are a health-care worker, student, military personnel or traveller, talk to your health-care provider. You may require two doses of MMR vaccine. If you are uncertain about whether you or your child should get immunized, contact your health-care provider or public health office. They can arrange to have you or your child receive a vaccination, which may be given within three days after exposure.

Who should NOT get the MMR vaccine?

  • Pregnant women
  • Anyone who has had a severe allergic reaction to a previous dose of the MMR vaccine, or to any of the contents of the vaccine (ex. neomycin).
  • Anyone with a severely weakened immune system. But, anyone with HIV infection should check with their doctor about getting the MMR vaccine.
  • Anyone who had immune globulins or any other blood products in the past year should speak to their doctor or public health nurse before getting the MMR vaccine.

Anyone who has any of the following should speak with a doctor or public health nurse before they are given the MMR vaccine:

  • A severe allergy to eggs
  • Thrombocytopenia (low platelets)
  • A history of convulsions (or family history)
  • Anyone who currently has a high fever. (The vaccine can still be given if the illness is mild, like a cold.)

Audra Kolesar is a registered nurse and manager with Health Links - Info Santé, the Winnipeg Health Region's telephone health information service.

The information for this column is provided by Health Links - Info Santé. It is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health care professional. You can access health information from a registered nurse 24 hours a day, seven days a week by calling Health Links - Info Santé. Call 204-788-8200 or toll-free 1-888-315-9257.

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