what a family doctor says you should know about measles
“we've forgotten the implications of these vaccine preventable diseases. they're not benign. they cause fatalities. they cause complications that are life-long. they change the trajectories of life.”
4 minute read
the vaccine, called mmr, protects against measles, mumps and rubella, and usually is given to children as a series of two doses—the first dose is given at 12 months and the second dose is given between ages four to seven.
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the rising case count of measles in many areas across the country has people worried and second-guessing their safety. can they send their kids to summer camp? should they still go ahead with vacation travel plans? and the big ‘what if’ someone in their household gets infected?
dr. christine palmay, a family medicine physician at midtown health and wellness clinic in toronto, is an advocate for prevention, doing whatever we can to protect our health: “good medicine treats disease. excellent medicine prevents disease,” she says of a quote she likes to stand by. “in a world of uncertainty where we now have threats to our health on so many different levels, ensuring that you’re practicing primary prevention is the best form of medicine. it’s not 100 per cent guaranteed, but nothing is.”
immunization is critical to prevent highly contagious measles
when it comes to measles, a highly contagious disease with high stakes for children, vaccination is critical to be protected. that’s what primary prevention for measles is all about, she says, noting the standard immunization protocols covered by public health in each province and territory.
the vaccine, called mmr, protects against measles, mumps and rubella, and usually is given to children as a series of two doses—the first dose is given at 12 months and the second dose is given between ages four to seven.
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the problem is uptake of vaccination is nowhere near ideal levels, even though introducing the vaccine led to eradicating the disease in canada in 1998. herd immunity in canada requires at least 95 per cent of the population to be immunized to prevent outbreaks, according to canada’s immunization guide.
the vaccine is about 95 per cent effective, so even for people who are fully vaccinated, there’s still a risk they can get measles. the vaccine, however, will protect against the more severe aspects.
vaccine-preventable diseases cause fatalities
“in canada, we had achieved to a certain extent full remission. but as things have changed and certainly during covid and now the things happening in the states, it’s quite tragic. we’re still trying to catch up from missed vaccines during covid layered upon an immediate threat within our backyard that is expanding,” palmay says.
“we’ve forgotten the implications of these vaccine preventable diseases. they’re not benign. they cause fatalities. they cause complications that are life-long. they change the trajectories of life.”
she never expected to see the re-emergence of measles and says that learning about vaccine preventable diseases during her medical training felt like a history lesson. as with most physicians, measles is something new to her practice and difficult to diagnose because symptoms are often vague until the rash develops. “it’s like a patchy ratch typically smooth on the face that moves down and you can get these lesions called koplik spots. they’re like bluish white spots on the mouth. that takes a while to evolve and a lot of these symptoms are pretty nonspecific like fever and runny nose. is it allergy, is it covid? so you can see how this gets missed. and patients are contagious for up to four days after [the rash appears].”
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right now, she has patients calling in to check on whether they’re up to date with vaccinations overall, which is an important step to prevention.
her message is all about knowledge surrounding measles and immunization: “educate yourselves. know what your vaccine status is. ask your primary care physician or ask public health what to do if perhaps you’re not up to date. if they can’t find that information, you may as well vaccinate yourself because you know right now, even if you are vaccinated, you’re at risk. so, it is a horrible time to start playing russian roulette with measles.”
people born before 1970, when vaccine records were different, likely need one dose of the vaccine as a precaution. as well, health officials are recommending that people born after 1970 who aren’t sure if they were vaccinated or have only received one dose of a measles-containing vaccine, should book an appointment to be immunized, unless they are pregnant or immunocompromised (they should talk to their care provider). the mmr vaccine isn’t advised during pregnancy because it contains live virus that could theoretically be transmitted to the fetus.
know your vaccine status before summer travel
and what about summer plans? again, immunization is key, palmay says. “things like camps with kids, planes, people are traveling. it’s a time where kids are going to be in group settings, so those vaccines need to be up to date.” if an infant under 12 months is travelling (especially to an area where there’s concern about measles) check with a physician to get the vaccination early and then have two doses given after 12 months.
what if you suspect you or your child has measles? palmay says the rule of thumb is to call public health. don’t drag yourself or your child to a clinic where you could expose everybody else. in cases where a child or a person gets severely sick and has problems breathing, put on masks and get to an emergency department and announce your possible measles right away.
what if you suspect you or your child has measles? palmay says the rule of thumb is to call public health. don’t drag yourself or your child to a clinic where you could expose everybody else. in cases where a child or a person gets severely sick and has problems breathing, put on masks and get to an emergency department and announce your possible measles right away.
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“you know, the last thing you want to do is send a measles case to daycare. so just be very judicious.”
for more information on the measles watch in canada, visit the federal government’s weekly monitoring report.
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