What you need to know about measles and vaccinations

WATCH ABOVE: Dr. Samir Gupta explains what parents should know about measles and its vaccination.

TORONTO – Toronto Public Health declared an outbreak of measles Monday after four people were diagnosed with the virus.

Measles is a highly contagious virus which spreads by small drops of fluid released when we cough or sneeze.  These droplets  can remain suspended in the air for hours, and 75 per cent of unvaccinated individuals who come into contact with an active patient will get infected.

READ MORE: Read Roald Dahl’s call for vaccination after his daughter died of measles

The infection starts with what we call a “prodrome” – a set of symptoms which starts before the main infection manifests itself – of pretty typical viral symptoms like fever and malaise, followed by conjunctivitis (red and painful eyes), runny nose, and cough.

People could also develop what we call “Koplik’s spots,” which look like grains of salt on a red background, inside the mouth. Next is a red rash that starts on the face and proceeds down the body, and from the center of the body outwards.

Measles can also cause complications – particularly in the very young, and in people with weak immune systems.  The most worrisome complications are pneumonia and encephalitis (infection of the brain). Either of the can lead to death.  Measles still kills hundreds of thousands of kids each year, primarily in countries without vaccination programs.

That being said, we know that the measles vaccine (MMR) works extremely well, but we also know that for various reasons, not everyone gets the vaccine.  Outbreaks occur when a group of people who are unvaccinated end up in the same place at the same time.  This is what happened with the Disneyland outbreak in the United States, with over 100 cases now, and with a large outbreak in Quebec in 2011, and in BC in 2014.

We know that there have been four cases in Toronto, three of whom were not vaccinated, and one of whom only got one of the two measles shots.  What is worrisome is that so far, public  health officials cannot identify a link between these four patients, or between any of these patients and known outbreaks around the world.

This suggests that these are sporadic cases and means we might see more cases related to these four patients in the next week or two.

Five things you should know about measles

What is the treatment for Measles?

If you weren’t vaccinated and are within 72 hours of exposure to a known case, we can administer an intravenous treatment and the MMR vaccine to boost your immunity, but there really is no treatment except prevention.

When should kids be vaccinated against measles?

The vaccine is first given at about 12 months, and because a small percentage of kids don’t respond to one shot alone, a second shot is given at age 4-6, ideally before entry into school.

Who is at risk of getting measles?

Basically anyone who didn’t get the vaccine – that includes kids who are not vaccinated because they’re too young (kids under age one), people who didn’t get vaccinated by choice, and people who couldn’t get the vaccine because of health reasons.

Who can’t receive the vaccine?

People with allergies to vaccine components,  pregnant women, and people with certain conditions that weaken the immune system can’t get vaccinated.  And ironically these are the people who are most susceptible to severe infections, which is why as a society we need to maintain high immunization rates, to protect our vulnerable (through “herd” immunity).

What if you’re not sure if you’ve been vaccinated?

We’ve had the vaccine since the mid 1950s, and provinces started immunization programs in 1967. Generally speaking if you’re born before 1970 in Canada, you have a high chance of natural immunity and don’t need vaccination.  If you’re born after 1970 in Canada or if you’re born elsewhere, and aren’t sure if you were vaccinated, you should go to your doctor and get a blood test to check if you are immune.  If you are not immune, get vaccinated.