Measles case confirmed in Halton – Measles exposure sites, information and vaccine info
Measles case confirmed in Halton – Measles exposure sites, information and vaccine info
Article
Quick facts
One confirmed, travel-related measles case has been reported to Halton Region Public Health.
Consider measles in the differential diagnoses, particularly in returning travelers with compatible symptoms including fever, cough, coryza or conjunctivitis and generalized maculopapular rash.
Significant public exposure sites include:
August 23 at the Real Canadian Superstore, Milton and Home Sense, Milton
August 25, 28 and 29 at the Santa Maria Medical Centre in Milton
August 29 at Milton District Hospital Emergency Department
August 29 to August 30 at Milton District Hospital Diagnostic Imaging and Pediatric Unit
Health care workers without documentation of proof of immunity, regardless of age of birth, will be excluded from work if exposed to a confirmed measles case. Ensure all staff in your office/clinic have documentation of either two doses of measles-containing vaccine OR laboratory evidence of immunity.
Immediately report all suspect or confirmed cases of measles infection to Halton Region Public Health by calling 311 or 905-825-6000. Do not wait for laboratory confirmation.
Schedule and assess the patient at the end of day in a single room with the door closed if an airborne infection isolation room is not available to promptly isolate the patient.
Provide the patient with a medical mask if able to tolerate use.
After patient assessment, do not use the exam room until at least two hours have elapsed.
Only health care workers with presumptive immunity to measles should provide care to patients with suspect/confirmed measles.
Do not wait for lab confirmation. Immediately report any suspected or confirmed measles cases to Halton Region Public Health by calling 311 or 905-825-6000. Call Halton Region Public Health to facilitate the transport of specimens to the Public Health Ontario (PHO) laboratory in Toronto for timely testing.
Advise the patient to self-isolate.
Note: If you are referring a patient for further assessment or diagnostic testing, the receiving facility must be notified ahead of the patient’s arrival to allow IPAC measures to be implemented.
Diagnostic testing
PCR specimens are essential for diagnostic testing. If feasible, collect ALL of the following:
Nasopharyngeal swab (within 7 days of rash onset) AND
Throat swab (within 7 days of rash onset) AND
Urine (within 14 days of rash onset)
For suspect cases with a high index of suspicion, it may be warranted to test beyond the time periods noted above. Refer to PHO Measles-Diagnostic-PCR (external link) for further guidance.
Specimens must be packaged separately from routine specimens and clearly marked “Suspect case of measles” and STAT on each laboratory requisition (external PDF) for PCR or diagnostic serology on the outside of the package. Complete all fields of the laboratory requisition form. Refer to PHO Measles-Diagnostic-PCR (external link) for information required for testing.
All requisitions for testing should have checked off the “diagnosis” box and contain the following information: patient symptoms and onset date, exposure, travel and vaccination history.
Ensure your office has testing specimen containers/supplies available. Review expiry dates of supplies. Swabs are currently being distributed with vaccine orders.
All Ontarians are eligible for one or two publicly funded doses of measles-containing vaccine depending on their age and risk factors. Refer to the Publicly Funded Immunization Schedule for Ontario (external PDF) for details on routine, high-risk and catch-up schedules.
Health care workers or military personnel: Two doses of the measles vaccine are recommended regardless of year of birth.
Ensure children who may have missed dose(s) of measles-containing vaccine are brought up to date as soon as possible. To be considered valid, doses must be given on or after the first birthday.
If immunization records are unavailable, immunization with measles-containing vaccine is preferred over serology. Refer to PHO Measles-Serology (external link) for details. Serology is not recommended before or after receiving MMR. If serology is inadvertently done, and the patient does not demonstrate immunity but has the required number of doses, re-immunization is not necessary.
Travellers to destinations outside of Canada should ensure they are adequately immunized against measles prior to travel. Refer to Canadian Immunization Guide (external link) for recommendations.
