Ask a nurse: measles and vaccinations

Mackenzie on nursing duty at SunRise.

With the recent outbreak of measles and talk in the media about the growing anti-vaccination movement, Mackenzie, Kids Cancer Care’s nursing manager, thought you may want to get the straight facts on this disease and on vaccinations in general.

As a member of Kids Cancer Care, we are part of a community that supports immuno-compromised children, who cannot be immunized due to their treatment regimen and are therefore vulnerable to infection. This is a responsibility that Kids Cancer Care takes seriously and, as a member of our community, I know it is something you also take seriously.

The spread of infectious diseases can be effectively mitigated by the immunization of eligible individuals. Immunization not only protects the individual, but also those at risk of infection. If you are interested in learning more about immunization safety and efficacy, please click here.  

About measles
Contrary to popular belief, measles is not a benign childhood disease. It’s actually a pretty nasty one. It’s potentially dangerous to long-term health and can even be life-threatening at times. It is strongly recommended that you seriously consider getting vaccinated against the measles.

Measles is a highly contagious disease caused by a virus in the paramyxovirus family. The measles virus infects the respiratory tract, and then spreads to the rest of the body. It can be spread when an infected person coughs or sneezes. The virus stays active and contagious in the air or on surfaces for up to two hours. It can also be spread through direct contact with an infected person. An individual with measles is contagious from one day BEFORE the onset of symptoms to four days AFTER disappearance of the red blotchy rash. (Alberta Health Services, 2019; Government of Canada, 2019; World Health Organization, 2018)

Measles vaccine
Before the introduction of measles vaccine in 1963 and widespread vaccination initiatives, major measles epidemics occurred approximately every two to three years and caused an estimated 2.6 million deaths each year. (World Health Organization, 2018) Measles vaccination prevented approximately 21.2 million deaths globally between 2000 and 2017, accounting for an 80 per cent drop in measles-related deaths.

Measles: complications and death
In 2017, despite the availability of a safe and effective vaccine, there were a total of 110,000 measles-related deaths worldwide. The majority of these deaths occurred in children under the age of five.  (World Health Organization, 2018)  

Most measles-related deaths are caused by complications associated with the disease. Approximately 40 per cent of infected individuals experience serious complications from the virus, including the following:

  1. Blindness  
  2. Encephalitis (an infection that causes swelling of the brain)  
  3. Severe diarrhea and subsequent dehydration
  4. Ear infections  
  5. Severe respiratory infections (e.g., pneumonia) (World Health Organization, 2018).

Serious complications are more common in children under the age five and in adults over the age of 30. (World Health Organization, 2018)

Measles in Canada
Although measles was eliminated in Canada in 1998, the disease is not uncommon in other parts of the world and Canada has imported cases of the disease through travel of unvaccinated individuals. 

In 2016, 11 laboratory-confirmed cases of measles were reported in Canada.Nine of the 11 cases were individuals who had not been vaccinated. The vaccination status of the other two were unknown. Five cases required hospitalization. All of the five hospitalizations involved children under four years of age. (Government of Canada, 2017; Government of Canada, 2019; Public Health Agency of Canada, 2019)

To date, in 2019, 51 laboratory-confirmed cases of the measles have been reported in Canada. These cases were reported in Quebec, British Columbia, the Northwest Territories, Ontario, and in Alberta. As of today, there are currently six active cases of measles in Canada including a recent case in Edmonton and area.  (Government of Canada, 2019; Public Health Agency of Canada, 2019)

Facts about measles

  1. Measles can be prevented with vaccination.
  2. Measles occurs worldwide and is a highly contagious respiratory infectious disease. Unvaccinated persons can catch this airborne virus by walking through a room up to two hours after an infected person was in the room.
  3. Symptoms include:
    1. Fever of 38.3°C or higher 
    2. Cough
    3. Runny nose
    4. Red eyes
    5. Red, blotchy rash that spreads from behind the ears onto the face, trunk, arms and legs and usually occurs three to seven days after the onset of fever
  4. An individual with measles is contagious from one day BEFORE the onset of symptoms to four days AFTER the disappearance of the red blotchy rash.
  5. There is no cure for the measles virus. Treatment is meant to manage symptoms of the virus and prevent serious complications.
  6. Measles is 100 per cent preventable with vaccination.  
  7. The measles vaccine is available as measles-mumps-rubella (MMR) or measles-mumps-rubella-varicella (MMR-Var).  
  8. Two doses of the vaccine are recommended to ensure immunity.
  9. The measles vaccine is recommended for routine immunization in children, susceptible adults born in or after the year 1970, susceptible health care workers, travellers and military personnel. (Alberta Health Services, 2019; Government of Canada, 2018; Government of Canada, 2019; World Health Organization, 2018)

Common Questions about Measles
If you have more questions about measles, please visit the Alberta Health Services immunization page here.

What is the recommended immunization schedule?
Click here for doctor-recommended immunization schedule.

What is Herd Immunity?
Herd immunity or community immunity occurs when large groups of people within a population are immunized. This helps to prevent the spread of communicable diseases, such as measles, and protect not only the individuals who have been immunized but also vulnerable members of the community who cannot be immunized. Infants too young to be immunized, individuals with compromised immune systems, patients undergoing cancer treatment, transplant recipients and the elderly rely on herd immunity to give them some degree of protection against some communicable diseases. (Alberta Health Services, 2019; Government of Canada, 2019)

Is Herd Immunity a good alternative to the measles vaccine?
For herd immunity to be effective and help prevent the spread of measles within a large group of people, 95 per cent of the population must be immunized against the disease. For children and adults who are able to be immunized, herd immunity does not give enough individual protection to be considered a good alternative to getting immunized. (Alberta Health Services, 2019; Government of Canada, 2019)

Where can I learn more about recommended immunizations?

Alberta Health Services has a wealth of peer-reviewed, research-based information on immunizations. You can find it here.

Where can I learn more about vaccine safety?
Questions or concerns?  Mackenzie Murawsky, Kids Cancer Care’s nursing manager, would very much like the opportunity to speak with you. Please feel free to contact Mackenzie by phone or email.

E mmurawsky@kidscancercare.ab.ca
T 403 984 6214

References
Alberta Health Services. (2019). Common Questions about Immunizations and Immunity.
Retrieved from http://immunizealberta.ca/i-need-know-more/common- questions/immunizations-and-immunity

Alberta Health Services. (2019). Common Questions about Measles. Retrieved from http://immunizealberta.ca/i-need-know-more/common-questions/measles

Government of Canada. Measles: For health professionals. (2019).
Retrieved from https://www.canada.ca/en/public-health/services/diseases/measles/health-professionals-measles.html

Government of Canada. Measles surveillance in Canada: 2016. (2017). Retrieved from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/measles-surveillance-canada-2016.html

Government of Canada. Measles vaccine: Canadian Immunization Guide. (2018).
Retrieved from
https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-12-measles-vaccine.html

Government of Canada. Public Health Agency of Canada. (2019). Measles in Canada.
Retrieved from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/measles-surveillance-canada-2016.html

Government of Canada. (2019). Weekly measles and rubella reports. Retrieved from https://www.canada.ca/en/public-health/services/diseases/measles/surveillance-measles/measles-rubella-weekly-monitoring-reports-2019.html

World Health Organization. (2018). Measles [Key Facts].
Retrieved from https://www.who.int/en/news-room/fact-sheets/detail/measles


2 thoughts on Ask a nurse: measles and vaccinations

Leave a Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.