Two cases of measles were confirmed in the Lower Mainland (Fraser Health and Vancouver Coastal Health) on February 16, 2025. These cases acquired measles during a recent trip to Southeast Asia.
Measles Exposure
Two cases of measles were confirmed in the Lower Mainland (Fraser Health and Vancouver Coastal Health) on February 16, 2025. These cases acquired measles during a recent trip to Southeast Asia.
Both individuals travelled on Air Canada Flight 66 that arrived on February 11 at 06:55 at Vancouver International Airport (YVR) during the period of communicability. The passengers on the flight have been notified directly. Additionally, people may have been exposed if they spent time in the international arrivals area of YVR, including customs or baggage claim, from 07:30 to 09:30am on February 11. Close contacts are being followed up individually by Public Health.
Measles Epidemiology
There has been a resurgence of measles activity in Canada with 44 cases in 2025, and 146 cases in 2024, and around the world. This is largely driven by declining uptake of measles-containing vaccine.
Measles vaccination is highly protective. One dose efficacy is 85-95% and two-dose efficacy approaches 100%. Given the resurgence in measles, we ask that physicians remain vigilant for cases of measles.
Measles Clinical Presentation
Measles initially presents with a fever, cough, runny nose, and conjunctivitis (Figure 1). Three to four days after fever onset, an erythematous maculopapular rash begins in the hairline, which then spreads rapidly to the face, trunk, and limbs. Koplik’s spots, if present, fade as the rash appears.
Figure 1. Clinical course of primary measles infection
Source: Manual for the laboratory diagnosis of measles and rubella virus infection. 2nd Ed. WHO (2007).
https://www.who.int/publications/i/item/WHO-IVB-07.01
History and Clinical Assessment
- Is your patient immunized? Collect immunization history for measles-containing vaccine(s) (e.g., MMR or
MMRV). This is an important protective factor. - Did your patient travel recently? Ask suspect cases about recent travel to areas with ongoing measles
transmission (e.g., Europe, Asia, Africa) as this is an important risk factor for acquiring measles. There have
also been recent outbreaks In Southwestern Ontario and parts of Quebec and parts of United States.
Laboratory Examination
- To confirm the diagnosis, please collect:
- Nasopharyngeal or throat swab (using a COPAN red top swab and with universal transport medium), AND
- Urine specimen (minimum of 5 mL) for measles virus detection by RT-PCR, AND
- Bloodwork for serologic testing (measles IgG and IgM; mark as ‘ACUTE measles’).
- If known, please also indicate date of potential exposure on the requisition.
- Please note on the form if your patient has recent history of MMR vaccination.
Preventing Further Transmission
- Please refer to recently updated PICNet Alert: Increase in Measles Activity
- Promptly isolate patients with suspected measles into either a private room or a negative-pressure room. Measles is airborne and highly infectious.
- The patient should remain masked during the entire appointment. Their exam room should not be used for two hours after the patient has left.
- Suspect cases will need to stay isolated at home until after their lab result returns negative, or at least four days after rash onset.
- Immediately notify Public Health (604-507-5471) of all measles cases (even if only suspected), preferably while the patient is in your office. Please contact Fraser Health MHO On Call for after hour clinical consults.
Immunization
- Please take this opportunity to immunize your patients against measles.
- Two doses of MMR vaccine are recommended for people born January 1, 1970, or later and for all health care workers born January 1, 1957, or later. Those born earlier are considered immune.
- Patients with an uncertain immunization history, orthose born before 1970 (or before 1957 for health care
staff) reporting no history of measles infection may also be immunized. - Two doses of MMR vaccine are currently offered to children at one year of age and kindergarten entry.
Measles vaccine before traveling
- Early vaccination is strongly recommended for families embarking on travel to measles endemic areas. This is generally for international travel.
- Infants: Children 6-11 months of age should be offered an early dose of MMR for protection. This dose will not count towards their series, but it will protect against travel related infection. It will need to be repeated at 12 months of age.
- Young children with one dose: Children who are travelling and have received their first dose of measles
vaccine at age 12 months should receive their second dose early, with a minimum interval of four weeks after
the first dose. - Older children and adults born after January 1, 1970, who are travelling should be offered an MMR if they are not certain they have had two previous doses.
Book your immunization appointment
- Call to book an appointment at a Public Health Unit.
- Telephone booking is available Monday-Friday, 8:30am-4:30pm.
- 604-702-4906 for residents of Mission, Abbotsford, Chilliwack, Agassiz, and Hope.
- 604-476-7087 for all other areas of Fraser Health.
- Click here for a list of public health unit locations.
- Book an appointment at a community pharmacy.
- Find a local pharmacy offering MMR vaccine here.