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Measles

Measles is a serious and extremely contagious disease. It is caused by a virus that spreads easily through the air, in which it can survive for several hours. Simply by sharing space with a contagious person, even for a short time, an individual can contract the infection and develop the disease.

Measles remains a major cause of infant mortality worldwide despite the existence of a safe and effective vaccine. In addition to the normal symptoms of the disease, measles can lead to complications, long-term effects, and, more rarely, death. Complications are more frequent among those whose immune systems are compromised by treatments or serious illnesses (such as leukemia), and among infants under one year of age.

Measles outbreaks in Québec

Since the beginning of 2011, Québec has been experiencing the largest outbreak of measles in the Americas since the disease was declared eliminated in 2002. The outbreak has particularly affected young people age 5 to 19. Cases of measles have been confirmed in the last few weeks in several regions.

View the final report on the provincial outbreak of measles in 2011.

The last measles outbreak was in 2007. Various regions were affected and a number of people were hospitalized. The 2007 outbreak aside, Québec has recorded between 0 and 4 cases of measles per year since 2001. Most were reported in individuals who had contracted the disease abroad in countries where vaccination was not widespread.

View the final epidemiological portrait of 2007 outbreak.

In 1989, during the last Québec measles epidemic, over 10,000 cases were reported. Those affected were mainly school-age children. Out of the 656 who were hospitalized, 10 developed encephalitis and 7 died.

The introduction of a vaccination program in the mid-1970s made it possible to prevent and reduce the occurrence of the disease. Although outbreaks have continued to take place in Québec, they have steadily decreased in intensity.

To find out about the spread of the disease in Québec prior to 1994: Use of a second dose of measles vaccine and intervention during outbreaks - Measles epidemiology - July 1994 (excerpt).

A school-based measles vaccination campaign is now underway to protect the public. For more information about the campaign or the vaccine:

Information for health professionals (French only).

Questions and answers

What is measles?

Measles is a very contagious disease caused by a virus that spreads easily through the air. Direct contact is not necessary for the disease to spread. The virus can survive in the air for a several hours. Being in the same place as an infected person who is contagious for a short period of time can be enough to catch the infection and then develop the illness.

Why are we hearing so much about the measles these days?

Since the beginning of 2011, public-health officials have noted an increase in measles cases in the province. Measles was once common in North America, but the disease is now rare as a result of vaccination campaigns initiated in the past that are still ongoing. The outbreaks now occurring in Europe account, in part, for the current outbreak in the province. The first cases reported in Québec were people who had contracted the disease while traveling in Europe or after being exposed to one of these travelers here in Québec.

What are the symptoms of measles?

Child with measles symptoms.
Source : Centers for Disease Control and Prevention, Public Health Image Library (PHIL).

A high fever, runny nose and cough are all symptoms of measles. A rash on the face and body, including the palms of the hands and soles of the feet, then develops. People who have the infection are affected by light and their eyes can hurt and get watery. The disease lasts 1 to 2 weeks. The incubation period (period between the time when a person is exposed to someone who is sick and when he or she develops symptoms) is about 7 to 14 days. An individual is contagious for 4 days before symptoms appear until 4 days after the rash develops.

Are there any complications from measles?

Common complications are ear infections (5% to 9%), lung infections (1% to 5%), convulsions, and, in 1 out of 1 000 cases, inflammation of the brain (encephalitis) that often causes permanent brain damage or mental retardation. Death occurs in 1 out of 3 000 cases. Complications are more common among people whose immune systems are weakened due to treatment or a serious illness (e.g. leukemia), and among babies under a year old.

Is measles dangerous for pregnant women or their unborn babies?

Pregnant women who get measles can have a more serious form of the disease, in addition to being at greater risk of spontaneous abortion or of not carrying the pregnancy to term. Pregnant women who have never had measles or who have not been vaccinated should see their doctor if they have been exposed to measles so they can receive appropriate care. Women who have had measles or who have been properly vaccinated do not need to worry.

What should I do if I have symptoms of measles?

Given the high risk of contagion, it is recommended that a person who has symptoms call before going to a medical clinic or health institution to let them know about their state of health. Information concerning precautions to take will be given to this person about how to avoid spreading the infection to family and friends as well as what to do upon arrival in the health care setting. People who are sick should not go to work or school, or participate in social activities as soon as the first symptoms appear and up to 5 days after the rash breaks out. There is no specific treatment for this disease, thereby highlighting the need for vaccination to protect oneself before coming into contact with an infected person. Recommendations are to stay in bed, drink plenty of fluids and take fever medication.

What can I do if I am exposed to someone who has measles?

Contact your doctor or the CSLC at your regional Health and Social Services Centre to check if you can get the vaccine or a shot of antibodies, depending on your state of health. Pregnant women who have never been vaccinated or never had the disease, infants under a year old, and immunosuppressed people can receive a shot of antibodies (immunoglobulin) that gives immediate protection if it is administered within 7 days of contact with someone who is contagious. Other people who come into contact can get vaccinated if they have never done so. The vaccine can effectively prevent measles if it is given within 72 hours following exposure to a case of measles.

Can measles be prevented?

Yes. Vaccination is the best way to protect yourself against measles. Québec’s vaccination schedule calls for a dose of Measles-Mumps-Rubella (MMR or RRO) vaccine to be given at 12 months and another at 18 months of age. To prevent epidemics, Québec conducted a “catch up” campaign in 1996. The campaign targeted children aged 18 months to 16 years. As a result, anyone born since 1980 should have also received 2 doses of measles vaccine for optimal protection.

Are there specific precautions for travelers?

Generally, travelers should check their vaccination records and that of children in their care to ensure all have adequate protection against measles. If not, they should contact their physician or the CLSC in their regional health and social-services centers to receive the vaccine.

Does the current outbreak of measles in the province mean that we should move up the date on which vaccination for children is schedule?

No. The vaccination schedule for children is unchanged. The first dose of MMR should be administered at 12 months and the second at 18 months.

However, a certain proportion of children 12 months or over have not received the vaccine yet. Even when there are no vaccine-preventable diseases going around, the vaccination schedule should be respected so that children are properly protected when they are more vulnerable.

The appearance of cases of measles in some regions of Québec reminds us that people who have not been vaccinated are vulnerable to the infection. Therefore, it is important to make an appointment as close as possible to a child’s first birthday and avoid delaying vaccination, even if several vaccines are supposed to be administered during a visit.

How do I know if I need to be vaccinated?

Measles was common before the 1970s when there was no measles vaccination programme. It is likely that people born before 1970 had the disease even if they do not remember getting it, and they probably do not need to be vaccinated. People born between 1970 and 1979 should have gotten one dose of vaccine. One dose is enough since these people are considered to have had natural boosters when they were exposed to various outbreaks that occurred between 1980 and 1989.

However, some people born during this period (1970 to 1979) should get 2 doses; they include individuals at greater risk of being exposed to the disease because of their work (health care workers) or because they travel to countries where measles circulates widely (travellers or military personnel).

When in doubt, contact Info Santé, your doctor or the CLSC that is part of the Health and Social Services Centre (CSSS) in your region.

Is the vaccine free in Québec?

Yes. You can get the vaccine free of charge at the CLSC that is part of the CSSS in your region, or from a vaccinating physician.

Is the vaccine safe?

Yes. The vaccine has been available and in use for about 30 years. It has proven to prevent and control measles, mumps and rubella. It is very safe. Most people have no reaction to the vaccine. Local reactions at injection site can occur but are short-lasting. Sometimes a person can develop fever and a temporary non-contagious rash 5 to 12 days after vaccination. Other side effects can also occur. For more details about the vaccine, consult the information sheets available on this site.

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