Measles | CMAJ – buffalobrewpub

Canada has been in measles elimination status since 1998, but remains vulnerable to outbreaks

Increased measles activity worldwide increases the risk of travel-related cases in Canada, which can spread quickly in unimmunized communities.

Measles is one of the most transmissible viral respiratory diseases

The measles virus is transmitted by respiratory particles (by inhalation or contact with mucous membranes) over short and long distances (e.g. airborne), even if airspace is only shared for a short time.1 Infection prevention and control measures are crucial to prevent prevent the spread of the pathogen to other areas. sensitive contacts. Healthcare facilities should be called before the patient arrives, and patients should be masked and immediately placed in an airborne isolation room, if available. Personnel must don personal protective equipment, including an N95 respirator.2

Clinicians should consider measles in patients who have traveled, been exposed to cases, or have a compatible clinical presentation

Measles presents with fever, cough, coryza, and non-suppurative conjunctivitis, with a maculopapular rash beginning on the face about four days later and spreading throughout the body. All patients with suspected measles should have a urine test and a nasopharyngeal or throat swab for virus detection by polymerase chain reaction, in addition to diagnostic serology (both immunoglobulin M and G).3

Ensuring that all children are up to date on measles vaccinations is imperative to preventing the return of endemic transmission in Canada

Most measles cases in Canada occur in unvaccinated people, especially children.4 Routine childhood vaccines missed during the COVID-19 pandemic need to be caught up urgently. Population immunity requires at least 95% vaccination coverage with 2 doses of measles-containing vaccine among age-eligible children. In Canada, the second dose is given at age 18 months or 4–6 years, depending on the province and territory.

Post-exposure prophylaxis may reduce the risk of infection or reduce the severity of measles in susceptible contacts

Measles, mumps, and rubella vaccine given to susceptible contacts 6 months or older within 72 hours of exposure to a case reduces the risk of developing measles.5 Immune globulin is recommended for susceptible contacts at high risk of complications (infants younger than 12 months). , people who are pregnant or have a weakened immune system) up to 6 days after exposure.5

Footnotes

Competing interests: Marina Salvadori is an employee of the Public Health Agency of Canada. Sarah Wilson is an employee of Public Health Ontario. No other competing interests were declared.
This article has been peer-reviewed.

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