Measles is a highly infectious virus. The vaccine has a >95% efficacy and persons 6 years of age should have received 2 doses. Persons born in or after 1970 may receive only one dose.
Clinically the features are fever of > 38.3, irritability/ill appearing, conjunctivitis, coryza, cough and a macular papular rash that starts on the face and then extends caudally and towards the extremities. Koplick spots on the inside lateral aspects of the mouth can be pathognomonic but may not be present. Acute encephalitis may occur in 1/1000 children. Patients with incomplete immunity may have atypical symptoms.
Incubation period 7-21 days. Travel history should be obtained as outbreaks occur sporadically due to suboptimal vaccine coverage (<95%) in some areas of the world and in Canada.
Cases of suspected measles should be reported to local public health officials.
Diagnostic laboratory testing includes both measles virus detection by PCR (nasopharyngeal/throat swab and urine) and diagnostic serology.
Requirement for submission of specimens to PHO are available here
Photos of measles infection are available here
Outbreaks of measles occur sporadically in areas where measles vaccine coverage for the population is <95%.
Measles exposure: Airborne precautions beginning 5 days after first exposure through 21 days after last exposure
Duration of precautions if confirmed: Until 4 days after onset of rash (longer in immunocompromised patients)
Only immune personnel and caretakers should enter the room. Immunoprophylaxis may be indicated for susceptible contacts.
Precautions should be taken with neonates born to mothers with measles infection at delivery.