MEDICAL ADVISORY: Measles Case in Niagara, May 8, 2019
Issued by: M. Mustafa Hirji, MD MPH FRCPC Medical Officer of Health & Commissioner (Acting)
Background
Niagara Region Public Health & Emergency Services is investigating a laboratory confirmed case of measles in an adult who acquired their infection while travelling outside Canada.
Airline exposure locations on April 28:
- Departing direct
flight, Philippine Airlines in Manila Philippines, Flight #PR118 at 4:55 p.m.
- Arriving flight, Toronto Pearson International Airport, Terminal 3 between the hours of 8 – 11 p.m.
Exposure location on May 1:
- Eastern Chinese Restaurant, 1 Stone Mason Drive, Markham, between the hours of 5 – 7:30 p.m.
Exposure location on May 2:
- Petro-Canada Convenience Store, 9249 Ninth Line, Markham between the hours of 9 – 11 p.m.
Exposure location on May 3:
- Niagara Health Welland Site, 65 Third Street, Welland, Emergency Room between the hours of 7 p.m. – 3:30 a.m.
Individuals who may have been to the above
mentioned locations are being asked to watch for signs and symptoms and to ensure their vaccinations are up to date.
Measles vaccination within 72 hours of exposure may provide some protection after exposure to measles, however in this particular case, that time window has passed. Therefore, we are recommending that you defer the vaccination for one month.
Recommended Testing for Suspected Measles Cases
Virus detection by PCR
- A nasopharyngeal swab or a throat swab. Specimens should be collected using the Viral Transport Media (VTM) collection kit (Item # N-0081). These swab kits contain pink liquid medium.
- In addition, collect approximately 50 ml of clean catch urine and store in a screw top sterile container. Ensure that the laboratory requisition indicates that this is a urine specimen and that you are requesting measles testing.
- Measles is stable at 4o Celsius for 3 days. Specimens must be stored and shipped cold. Freeze samples at -70o Celsius if a delay in transport is anticipated.
Acute Serology
- A blood specimen (5 ml collected in a serum tube) for measles antibodies (IgM and IgG) should be collected at the first visit (ideally within 7 days after rash onset).
Measles Vaccination
Recommendations
- Two doses of measles vaccine is recommended for anyone born after 1970
- Please refer to the measles information on our website at niagararegion.ca/health
Infection Prevention and Control Practices
- Patients with suspected measles should wear a surgical mask and be immediately placed in a single room with the door closed
- Measles virus can remain airborne for two hours, no further patients should be placed within the room for a two-hour
- You may consider giving patients with suspect measles the last appointment of the day
- Only immune staff should provide care to suspect cases of
measles
Reporting
Please report all suspect and confirmed cases to Niagara Region Public Health & Emergency Services, Infectious Disease program immediately at 1-888-505-6074 or 905-688-8248 ext. 7330, Monday to Friday 8:30 a.m. to 4:30 p.m., after hours at 905-984-3690.