Measles

What is measles?

Measles, also known as Red Measles or Rubeola, is a very contagious viral infection that can cause serious illness. 

Because of vaccines, measles is now rare in Canada. However, measles cases are on the rise around the world, and now here in Canada. At this time, the risk of measles remains low in Nova Scotia. Most cases occur in unvaccinated people who have travelled to places where measles cases are occurring. When people develop measles while traveling, they can spread the disease to others, including infants too young to be vaccinated.

The best way to prevent measles is to be vaccinated with two doses of vaccine.

Who is eligible for a measles-containing vaccine?

Measles-containing vaccines are part of the routine immunization schedule for Nova Scotians:

• 2 doses of Measles, Mumps, Rubella, Varicella (MMRV) vaccine at 12 months and 18 months old
• 2 doses of Measles, Mumps, Rubella (MMR) vaccine for people born in 1970 or later

Travellers are eligible for additional measles-containing vaccines:

• 1 dose of MMR vaccine for infants between 6 months and 12 months old 

  Children who receive a measles vaccine for travel between 6 months and 12 months old require two doses of MMRV vaccine after their first birthday to complete the routine series and be fully protected.

• 1 dose of MMR vaccine for adults and adolescents without measles immunity.

Eligible individuals can receive measles vaccine free of charge. If you have questions about eligibility, please discuss with your immunizer.

Who has measles immunity?

People are considered to have measles immunity if they have had a previous lab-confirmed measles infection, or have been vaccinated with two doses of measles vaccine. 

Who can get measles?

Anyone without measles immunity can get the disease. The chance of getting measles is reduced if you have been fully vaccinated against it.
Measles vaccines include:

• MMR (Measles + Mumps + Rubella)
• MMRV (Measles + Mumps + Rubella + Varicella [Chickenpox])

Some people are at higher risk of developing severe complications from measles, including:

• pregnant people
• people with weakened immune systems
• children under 5 years old

You’re more likely to become infected if you do not have measles immunity, or are travelling to places where measles is a concern. Before travelling make sure you and your family are fully vaccinated. Find your vaccine records - www.nshealth.ca/immunizations.

What are the symptoms of measles?

Symptoms can appear 7 to 21 days after being infected with the measles virus. People infected with measles can spread it to others before they have symptoms.

Initial symptoms include:

• fever
• cough
• runny nose
• red, watery eyes

Small, white spots may appear inside the mouth and throat 2 to 3 days after symptoms begin.
About 3 to 7 days after symptoms begin, a rash that looks like small red spots:

• develops on the face
• spreads down the body, arms and legs

The rash can last 4 to 7 days. Most people recover from measles within 2 or 3 weeks.

What if I, or my child, feels ill?

If you or your child develop symptoms of measles, isolate at home and call a healthcare provider immediately. Let the healthcare facility know that you or your child might have measles, and if you recently travelled. They will take appropriate precautions to prevent spread to others as soon as you arrive.

Do not go to a healthcare facility or office without calling ahead first.

How does measles spread?

• Measles is an airborne virus which spreads very easily from person to person.
• Measles is passed from an infected person to others through coughing, sneezing and even talking. 
• Measles can stay in the air up to two hours after an infected person has left the room/confined space.
• You can catch measles just by being in a room where a person with measles has been, up to two hours after that person is gone.
• Measles is able to be spread from four days before to four days after the rash begins.

The virus can also be spread in following ways by a person with measles:

• kissing, sharing food, drinks or eating utensils, being in the same room 
• sharing toothbrushes, mouth guards, towels, cigarettes or lipstick
• sharing toys (young children) or musical instruments

How can measles be prevented?

The best way to protect against measles is to be vaccinated. A single dose of measles vaccine is estimated to provide 85% to 95% protection, however with a second dose, it increases to almost 100%. In Nova Scotia, children are routinely vaccinated with two doses of the measles vaccine at 12 and 18 months old using the measles, mumps, rubella and varicella (MMRV) vaccine. 

People without measles immunity should contact their healthcare provider or call Public Health to be vaccinated. If planning to travel to places where measles is a concern, consult with a healthcare provider to ensure you and your loved ones are up-to-date with your vaccines. 

People with measles should not go out in public places, attend childcare, school, or work for four days after the rash appears. Covering your nose and mouth when coughing or sneezing, disposing soiled tissues, washing hands well and not sharing eating utensils, food or drinking cups will also help to reduce the spread of infection.

I am travelling with an infant, should they get a measles vaccine?

If you are travelling to places where measles is a concern, an early dose of measles vaccine may be given to children between 6 and 12 months old to protect them. Your baby will still need to get two further doses of measles vaccines after their first birthday.

If you or your child need a measles vaccine you can do the following:

• Contact your primary healthcare provider, if you have one.
• Contact a primary care pharmacy clinic
• Find a Public Health Immunization Clinic in your area offering the vaccine
• Contact your local Public Health Office 

Should I get vaccinated before travelling? 

Adults without measles immunity who are travelling to areas where measles is a concern should speak to their healthcare provider or contact Public Health to decide whether a vaccine is needed. 

Vaccine recommendation for adults without measles immunity:

• Adults born in/after 1970 - two doses of measles vaccine
• Adults born before 1970 - one dose of measles vaccine

See “Who has measles immunity” above for information on measles immunity. 

Anyone without measles immunity who is travelling to places where measles is a concern should check for health notices before travelling, and speak to a healthcare provider to determine if they should be vaccinated. Travel health notices are available at https://travel.gc.ca/travelling/health-safety/travel-health-notices.

I’m pregnant, should I get the measles vaccine?

The measles vaccine is a live vaccine and therefore it is not recommended that pregnant people be vaccinated for measles until after they give birth. However, it is recommended that everyone within the same household be up to date on vaccinations to protect you and your baby, lowering the risk of infection.

Do I ever need a booster dose?

No. People who have had all recommended doses of measles vaccine are protected for life, they do not need a booster dose.

If you’re not sure whether you are fully vaccinated, talk with your healthcare provider or call Public Health. 

What if I’m not sure if I, or my family, have been vaccinated?

If you’re unsure whether you’re immune to measles, you should first try to find your vaccination records or documentation of measles immunity. 

If you do not have written documentation of measles immunity, you should get vaccinated with a measles vaccine. There is no harm in getting another dose of vaccine if you may already be immune to measles (or mumps or rubella). 

Find your vaccine records - www.nshealth.ca/immunizations.

How long does it take the measles vaccine to work in your body?

For the measles vaccine to work, the body needs time to produce protective antibodies in response to the vaccine. Detectable antibodies generally appear within just a few days after vaccination. People are usually fully protected after about 2 or 3 weeks. 

If you’re travelling internationally, make sure to get up to date on all your measles shots. You should plan to be fully vaccinated at least 2 weeks before you depart. If your trip is less than 2 weeks away and you’re not protected against measles, you should still get a dose of measles vaccine.