Medical Advisory: Measles Cases in Niagara, Update 2

Issued by: Dr. Azim Kasmani, MD, MSc, FRCPC, Medical Officer of Health and Commissioner
Date: March 5, 2025

There is a multi-jurisdictional measles outbreak in Ontario. At this time, Niagara Region Public Health (NRPH) is reporting three new confirmed cases of measles in children who have not received measles-containing vaccination.

We expect to see an increase in cases and request that all health professionals be on heightened surveillance.

Exposure location on Sunday March 2, 2025, between the hours of 4:20 p.m. - 6:20 p.m.:

MedCare Clinics at Scott Street Medical Centre, 387 Scott Street, Unit A2C St. Catharines

Individuals who were at this location during the exposure time are being asked to watch for symptoms for 21 days and to ensure their vaccinations are up to date. NRPH will be completing case and contact management for confirmed cases. Contacts eligible for post-exposure prophylaxis (PEP) will be managed by NRPH in collaboration with Niagara Health. If you have any patients identified as a contact, please encourage them to reach out to NRPH to discuss eligibility.

Reporting

Please report all suspected 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 905-984-3690.

Infection Prevention and Control Practices

When possible, patients with suspected measles should be given the last appointment of the day
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 period
Only staff who have received two doses of measles-containing vaccine, or with history or previous infection, should provide care to suspect cases of measles
If patient requires laboratory services or assessment at another health care facility, please call ahead to that facility to ensure IPAC practices are followed

Recommended Testing for Suspected Measles Cases

Specimen Collection:
- Indicate STAT on lab requisitions. Include travel history and vaccination status on the requisition
- Recommended samples:
  - Nasopharyngeal and/or throat swab PCR (within 7 days of rash onset) AND urine PCR (within 14 days of rash onset)
  - Refer to PHO Measles-Diagnostic-PCR guidelines for details
- It is NOT recommended that serology be ordered as the only test for measles diagnosis. Refer to PHO Measles – Serology for details.
- To facilitate timely testing when needed, ensure specimen collection supplies, including viral swabs, are readily available. To order specimen collection supplies, use the PHOL Requisition for Specimen Containers and Supplies. See PHOL Kit and Test Ordering Instructions for more information.
Provide isolation guidance to the patient while test results are pending.
- Please instruct patient to stay home and self-isolate from all public places such as childcare settings, schools, post-secondary educational institutions, workplaces, places of worship, sporting events, healthcare and other group settings; avoid contact with any non-household persons

Measles Vaccination Recommendations

Measles vaccine recommendations remain unchanged. Please refer to the Medical Advisory: Increased Measles Activity in Ontario for details.
Residents are directed to reach out to their health care provider or go to a walk-in clinic for vaccination (must not be identified as a measles contact and cannot be infected with measles at the time)
- Note that NRPH is currently focused on providing vaccination to children who do not have access to a primary care provider
Use the General Vaccine Order Form to place an order for vaccine
Please anticipate an increase in requests for vaccine record information

More Information

Measles information for health care providers – Public Health Ontario
Contact the Infectious Disease Program at:
- 905-688-8248 or 1-888-505-6074 ext. 7330
- After-hours: 905-984-3690
For vaccine related questions, call the Vaccine Preventable Disease program at 905-688-8248 or 1-888-505-6074 ext. 7396. Please state that you are a health care provider, and we will prioritize your call during times of high call volume.