British Columbians are being encouraged to get the measles vaccine following an outbreak of cases across the country.
B.C.'s first case of measles since 2019 was identified in the Vancouver Coastal Health (VCH) region, sparking concern among health officials. A public warning was issued on Monday, March 4.
While the case has been linked to travel outside of Canada, there is concern over community spread among unvaccinated individuals. In particular, people who were recently at the Vancouver Airport Hotel and the ICBC Centre on No. 3 Road may have been exposed to the highly infectious virus.
Measles was a common disease before a vaccine was developed but has been eliminated in Canada. However, 17 cases of measles have already been reported in other parts of Canada this year. There were only 12 in all of 2023.
Montreal is currently considered the "epicentre" of Canada's measles outbreak, with 10 cases.
What are the symptoms of measles?
Measles symptoms in adults are the same as in children but they can be confused with other viruses.
Dr. Davidicus Wong, a family physician based in Burnaby, told V.I.A. that the disease stays dormant for several days before an infected person begins showing symptoms. It may take anywhere from seven to 14 days for the individual to feel ill.
The initial onset of symptoms include high fever, cough, runny nose, and "inflamed" watery eyes, and may be confused with anything from the flu to allergies to COVID-19. However, a physician may identify a rash easily once it develops.
"The classical rash starts on the face and then spreads to the trunk and then arms and legs," he explains.
The BC Centres for Disease Control (BCCDC) advises people to check for the following symptoms of measles.
- Fever, cough, runny nose, and watery inflamed eyes
- In the mouth - small red spots with white or bluish-white centres
- Dusky red, blotchy rash that begins on the face and spreads all over the body
- The rash begins on the third to seventh day of illness and lasts four to seven days
How long is a person contagious with measles?
People are contagious with measles four days before the rash appears and four days after it is completely gone, meaning that they may unknowingly spread the virus to others.
Wong says it is best to stay home as soon as you feel ill to avoid spreading measles or any other virus to people around you. The virus can stay in an enclosed area, such as an elevator, for as long as two hours after an infected person has been in it.
How can you prevent spreading or being infected by measles?
Receiving the measles vaccine is the best way to prevent spreading or being infected by the virus.
"The thing with measles as a virus is that it is incredibly contagious," Wong underscored. "If you're in an elevator with someone who has it, there is a 90 per cent chance you'll get it."
A full course of the MMRV (measles, mumps, rubella, and varicella) vaccine, or two doses, provides nearly 100 per cent protection against infection.
The MMRV vaccine can be given to children aged 12 to 15 months, providing 85 to 95 per cent protection against the virus. A second dose is typically administered before they go to school, Wong explained.
While vaccination is the best way to prevent being infected, a surgical face mask also protects against the virus because it is airborne, said Wong.
Does the measles vaccine have side effects?
There may be some minor aches and pains associated with taking the measles vaccine but severe risks are extremely low. In contrast, the chance of developing severe complications from the virus is not uncommon.
Dr. Brian Conway, medical director of the Vancouver Infectious Diseases Centre (VIDC), told V.I.A. that measles is the most contagious disease that is preventable by a vaccine.
About one out of 10 people will have ear infections or pneumonia after contracting measles, while roughly one in a thousand will develop encephalitis (swelling of the brain), which may cause permanent brain damage. It may also cause deafness, blindness, convulsions, and in children, according to the BCCDC.
About one in 3,000 people infected with measles die from respiratory and neurologic complications.
People can have an allergic reaction to the measles vaccine but these incidents are rare, indicated the BCCDC. If your child has trouble breathing, a high fever, or anything unusual after receiving the shot, immediately contact a doctor.
Do not get the vaccine if you feel ill, cautions the BCDC, which advises you should wait until you feel better.
How do I know if I'm fully vaccinated against measles?
People born between 1970 and 1983 may have been given one dose of the MMRV vaccine but should receive two. In these cases, a physician or healthcare provider can provide a booster dose. The most recent measles vaccine was introduced in 1983.
Wong said a physician can do a blood test for people who are unsure if they have received a full course of the vaccine. This is a particularly good idea for people who are looking to travel outside of Canada.
Most people born before 1970 are considered immune to the disease because they have likely had it at some point. However, they should consult a healthcare provider and get the vaccine.
Babies as young as six months should be vaccinated against measles before travelling to countries where the disease is spreading, says a joint bulletin issued by provincial health officer Dr Bonnie Henry's office, the provincial government, and the BCCDC.
Children between the ages of 12 months and four years can also get their second dose before travelling outside the country.
How high is the chance for community spread of measles in Metro Vancouver?
Like other infectious diseases, measles can rapidly spread through communities with low immunization rates.
Thanks to a robust vaccination campaign, the disease was eliminated in Canada in 1998. However, childhood immunization rates dropped in B.C. and around the world over the pandemic.
The U.S. Centres for Disease Control says that the COVID-19 pandemic worsened the spread of measles because over 60 million doses of measles-containing vaccine were postponed or missed from 2020 to 2022. It also shows a list of countries with the highest numbers of cases. The top three countries with the most infections are Yemen with 18,464, Azerbaijan with 13,721, and Kazakhstan with 13,195.
The World Health Organization reported a 79 per cent increase in the number of global measles cases in 2023 compared with the previous year.
Conway said other parts of Canada are seeing cases of the disease climb but people don't need to limit travel to other provinces.
The risk of community spread in Vancouver is low but people should ensure they are fully vaccinated. If they have measles symptoms, they should see a doctor, he added.
"The healthcare authorities are on it; let's give them a chance to do their work," he said.
People should also ensure they are protected against other viruses, including RSV, shingles, the flu, and COVID-19.
With files from the Richmond News and the Canadian Press.
