The BC Centre for Disease Control (BCCDC) is asking health- care professionals and the public to be alert for measles after several people in the Lower Mainland were recently diagnosed with the disease.
In the past two weeks, 10 laboratory confirmed and four suspect cases of measles have been identified in the Lower Mainland of British Columbia, including an out-of-province visitor. Eight of the 14 cases are associated with a single household with unvaccinated members. It is suspected that at least two out-of-country visitors brought measles into Vancouver sometime in February or early March, as two separate strains of the virus have been identified. Susceptible people exposed to these imported cases would have developed measles by now if infected. Several cases have occurred because the first B.C. cases spread the infection to others.
A separate case of measles has also been confirmed in the same time period in a returning traveller from India coming home to the Interior of B.C.
None of the cases identified to date had two doses of measles vaccine, which is needed for full protection. Many were unimmunized because of philosophical objections, and some had a history of only receiving a single dose of measles vaccine or did not know their immunization status.
Overall the risk for the general population remains very low because most children routinely receive the vaccine between their first and second birthdays. "Most years, we see no cases of measles in B.C. because our vaccination rates are high," said Dr. Monika Naus, immunization director for the BCCDC. "Nevertheless, these cases show that with global travel, even a vaccine preventable disease - as rare as measles is now in Canada - is still only an airplane ride away."
Measles is a highly contagious viral illness spread through airborne contact with the virus. The illness begins with a fever, runny nose and cough. Several days later, a rash appears around the face and then spreads to the chest and limbs. The eyes may be red and very sensitive to light.
Anyone who suspects they have measles should immediately contact their doctor by telephone first or call the HealthLink BC at 811. "Measles is particularly contagious," said Naus. "So contagious that people with measles should avoid exposing others, especially in medical waiting rooms and emergency rooms." Physicians are required to immediately report suspected cases of measles to public health authorities.
Current guidelines for vaccination against measles are that people born after 1956 should have two doses of measles containing vaccine. The vaccine is available as measles, mumps and rubella (MMR) vaccine and usually given to children at the first birthday and at 18 months of age. In 1996, B.C. took part in a nationwide campaign to eliminate measles by giving a dose of measles-containing vaccine to all children starting as young as 18 months and adolescents through high school, including offering the vaccine to college/university students. Subsequently a routine second dose was added to the immunization schedule.
The message is simple as how best to avoid the disease: get immunized. "Whether it's measles, mumps, rubella, or a host of other vaccine- preventable diseases for which we have vaccines, the best thing anyone can do is to make sure that their vaccinations are up-to-date," continued Naus. "Two doses of measles vaccine are 99 per cent effective against the disease. Those are pretty good odds. The vaccine is especially recommended for school children, post-secondary students, health-care workers and travellers, but also for anyone born after 1956."
Measles can cause serious and sometimes permanent health problems. It often causes an ear infection or pneumonia. One person in every 1,000 with measles has an inflammation of the brain (encephalitis). Encephalitis can lead to convulsions, deafness or permanent mental disability. One person in every 3,000 with measles may die of complications.
The measles vaccine is usually given in a form that also includes protection against mumps and rubella. It takes about two weeks for the vaccine to confer immunity.
For more information on Measles, please view the BC HealthFiles on
Measles at www.bchealthguide.org/healthfiles
or visit: www.bccdc.ca