Measles alert to health care providers - new case of measles

Based on this measles activity, we are asking you to:

• Ensure you and your patients’ measles immunizations are up to date
• Be vigilant for cases of measles, especially in returning travelers or individuals linked to a confirmed case
• Ensure all suspected cases of measles are isolated as quickly as possible
• Contact Public Health to report all suspected cases

Symptoms of Measles

The clinical presentation of measles is a 2 to 4 day prodrome of fever, coryza, conjunctivitis and Koplik spots (clustered, white lesions that look like grains of white sand with a bit of a red surround on the buccal mucosa opposite the upper 1st & 2nd molars) followed by a maculopapular rash that begins on the face at the hairline and then becomes generalized. The infectious period may precede the onset of prodromal symptoms by 1 to 2 days and continues until 4 days after onset of rash.

Infection Control for Suspected Measles

• All patients presenting with symptoms of measles (e.g., a fever and rash) should be masked immediately and placed on isolation precautions as quickly as possible. Patients with suspected measles should be placed under Airborne Precautions (and droplet precautions if airborne precautions are not available).
• Measles transmission can occur up to two hours after a measles infected person has left the room. Therefore the clinic room used to assess a patient with suspect measles should not be used for two hours after the patient with suspect measles leaves the room.
• Advise patients to wear a mask upon leaving the clinic and/or if they present to any other healthcare facility, such as a laboratory, emergency department or other clinic.

Testing for Measles

Please collect an NP swab and urine for PCR virus isolation, AND blood for serologic testing (measles IgG and IgM). Specimens should be sent directly to the Provincial Laboratory.

Reporting to Public Health

• Physicians who suspect measles should call their local Public Health Unit while the patient is still present to initiate immediate public health follow-up, appropriate isolation, and testing.
• After office hours, please call 604-527-4806, and ask for the Medical Health Officer on-call.