The following is a message from Dr. Laura McDougall, Senior Medical Officer of Health, Alberta Health Services:
More than 35 measles cases have been identified in all five zones of Alberta Health Services since February, with evidence of community spread in some parts of the province. Cases also continue to increase in several Canadian provinces, and outbreaks are being reported in numerous countries and travel destinations globally.
- For information on measles in Alberta, we encourage you to please regularly visit ahs.ca/measles.
- For information on case numbers, please visit alberta.ca/measles.
Reducing spread, preventing transmission
Measles is extremely contagious and the virus spreads easily through the air. The highly effective vaccine – that has a long-proven record of safety – provides strong protection.
To reduce spread in our settings, all healthcare workers are advised to have evidence of immunity. This includes
- two valid lifetime doses of measles-containing vaccine (for example, MMR). (All healthcare workers are eligible, regardless of year of birth), OR
- a documented laboratory-confirmed measles infection in the past, OR
- a blood test showing proof of immunity. NOTE: testing for antibodies to determine immunity is not routinely recommended.
Healthcare workers without previous evidence of immunity are strongly recommended to receive measles-containing vaccine to ensure they have a total of two valid doses documented. See the AHS Staff FAQ for more details; note that though this is specific to AHS staff and staff covered under service agreements with AHS, it can be considered in context of different health care settings.
Benefits of healthcare worker immunity
Workers who are immune and asymptomatic are not subject to work restrictions after exposure. Increasing immunity across the workforce protects staff, reduces the risk of transmission to others — including immunocompromised patients — and helps preserve the capacity of the healthcare system.
Healthcare worker personal protective equipment (PPE)
AHS and other workers under service agreements with AHS Workplace Health and Safety (WHS), who are providing direct care to patients with suspected or confirmed measles must wear a fit-tested, seal-checked N95 respirator, regardless of their immunization status, in alignment with Airborne Precautions and infection prevention and control standards.
Other infection prevention and control (IPC) measures
Patient routing, environmental controls, and ensuring safe designated family support and visitation help reduce the risk of measles transmission to patients, visitors, and staff. In addition, it is essential to promptly identify and isolate suspected cases and adhere to recommended infection control practices.
Know what to do if you’re exposed
Leaders within AHS and with organizations under service agreement with AHS provide lists of exposed workers to AHS WHS for review and follow up. If you think you may have had a workplace exposure to measles at an AHS/service agreement site, and were not contacted, please reach out to AHS WHS directly.
If you work for AHS and believe you have been exposed to measles outside of work, contact AHS WHS. The Occupational Health Nurse will advise if you need to be off work.
If you are exposed to measles in a workplace setting outside of AHS or a facility covered under service agreement, please follow your own organization’s Workplace Health & Safety policies and guidelines. If your organization does not have its own Workplace Health & Safety program, you may be contacted by AHS Communicable Disease Control.
Information for your patients
You can encourage patients to
- Check their immunization records.
- Albertans uncertain of their immunization history can text ‘measles‘ to 88111 or call Health Link (811) or their local public health or community health centre.
- Individuals 14 years of age and older can check their My Health Record account immunization record.
- Call Health Link at 811 before visiting any healthcare facility, including their family physician or healthcare provider if they have measles symptoms.
Information for yourself and your practice or care setting
Case identification in your practice or care settings
Please watch for symptoms of measles, including
- fever of 38.3° C or higher; and
- cough, runny nose and/or red eyes (the 3 C’s: Cough/Coryza/Conjunctivitis); and
- a rash that appears three to seven days after fever starts, usually beginning behind the ears and on the face and spreading down to the body and then to the arms and legs. The rash appears red and blotchy on lighter skin colours. On darker skin colours, it can appear purple or darker than the skin around it, or it might be hard to see. View measles rash images.
If you have a patient with these symptoms, please order testing as outlined in the APL Lab Bulletin. Guidance on how to arrange clinical specimen collection is also now available here.
While awaiting results, please advise outpatients to isolate at home and ensure inpatients are on airborne precautions.
Public Health actions
If you suspect measles in a patient, you must notify the Zone Medical Officers of Health (MOH) at the following numbers:
- Calgary Zone: 403-264-5615
- Central Zone: 403-356-6430
- Edmonton Zone: 780-433-3940
- North Zone: 1-800-732-8981
- South Zone: 403-388-6111
Masking reminder
Please remind all patients who have been asked to isolate because they’re a contact of someone with measles, have symptoms of measles, or are accompanying someone with suspected measles, that they are encouraged to mask to help protect patients, visitors, and staff, at any healthcare facility. This provides source control, helping reduce the risk of infectious particles being released into shared spaces during movement through the facility. Surgical masks in this context are not a substitute for airborne precautions, but serve as an added layer of protection in shared or transitional spaces. More on IPC Recommendations for Measles.
Protection via immunization
As noted above, it is strongly recommended that anyone who works with patients or clients ensure they have documented evidence of being immune to measles, regardless of year of birth.
In Alberta, measles vaccine is offered, free of charge, through Alberta’s publicly funded immunization program. Children in Alberta typically receive their first dose of measles vaccine at 12 months of age, and their second dose at 18 months of age.
People born in 1970 or later with a documented history of two life-time doses of measles containing vaccine spaced at least four weeks apart, or those who have a history of lab confirmed disease or serological evidence of measles immunity, are considered protected. Adults born before 1970 are generally considered immune to measles, as the virus circulated widely before that time.
Additional immunization recommendations apply to Albertans who are travelling to or reside in areas where measles is currently circulating. This includes all locations outside of Canada, and some areas within Canada and Alberta. In these areas, infants who are six months up to and including 11 months of age are recommended to have an early dose of vaccine and adults born before 1970 are also eligible for a single lifetime dose. This information will change over time, and it is important to check Measles | Alberta.ca for the most up to date immunization recommendations and affected areas.
Essential resources for healthcare providers
- Measles Primary Care Summary Guide,
- Provincial Measles Primary Care Clinical Pathway, and
- Environmental Cleaning Guidelines in Community Clinics.
Excellent resources for all Albertans
