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Measles in Alberta: what primary care nurses need to know


 

Measles cases have been on the rise globally. Alberta Health Services announced a measles case was identified in Edmonton the week of April 20, 2024. Here is the attached news bulletin of potential exposure locations and instructions on what to do if you think you may have been exposed: https://www.albertahealthservices.ca/news/page18174.aspx

 

What is measles?

Measles is a disease caused by a virus. Symptoms of measles include:

·         A fever AND

·         A cough, runny nose, and/or red eyes AND

·         A blotchy red rash starting 3-7 days after the fever starts. The rash starts behind the ears and on the face, the spreads down to the body and to the arms and legs

 

Measles can be dangerous:

·         1 in 10 people with measles will get an ear or lung infection

·         1 in 1000 people with measles will get encephalitis which can lead to seizures, deafness, or brain damage

·         2-3 of every 1000 people with measles die

 

How does measles spread?

Measles is extremely contagious. Measles is airborne, meaning you can catch it from being in the same area as someone who is contagious. Measles can linger in the air inside for 2 hours after someone contagious has been there. Also, people with measles are contagious starting 1 day before they have symptoms (which could be up to a week before they ever have a rash and suspect they could have measles).

 

Who is more at risk?

Measles tends to be more severe in babies and adults, but anyone can potentially have complications from the disease. Up to 90% of people who are not immune to measles will become infected if they are in close contact with someone who has it.

 

How do people protect themselves?

There is a safe and effective vaccine to protect against measles called MMR.  It protects against measles, mumps, and rubella. It is offered for free through public health for those eligible. Measles vaccines have been available since the 1960s in Canada- prior to that, there were upwards of 60000 cases of measles yearly in the country.

 

Children in Alberta aged 12 months and older receive 2 doses of the vaccine as part of their routine childhood immunizations (currently at the 12- and 18-month vaccination appointments).

Adults born on or after 1970 are considered immune if they have had either a lab confirmed case of measles, or 2 doses of a measles-containing vaccine.

Adults born before 1970 are generally considered immune due to the likelihood of their exposure to measles when they were younger.

 

If people are unsure of their immunization status, they can call HealthLink at 811 or text “vaccine record’ to 88111. Vaccine records are also available through the myhealthrecords portal:  https://myhealth.alberta.ca/myhealthrecords

 

What can I do as a primary care nurse to help?

·         Ensure you are protected from measles: It is recommended that all Health Care Workers should receive 2 measles containing vaccines, regardless of the year they were born

·         Encourage vaccination: encourage everyone, patients and loved ones alike, to check their vaccine records and receive the MMR vaccine if they aren’t protected/fully protected

·         Keep up to date on public health recommendations for your community and share them with your patients

·         Be prepared to participate in discussions at your work locations on safety protocols for staff and patients

 

What personal protective equipment (PPE) is recommended when in close contact with a patient with suspected or confirmed measles?

·         Measles is considered an airborne virus, so airborne precautions are recommended for anyone in close contact with a suspected or confirmed case:

o   Fit-tested N95 respirator

o   Eye protection

o   Gloves

o   Gown

·         The patient should wear a medical mask and be in a negative pressure room. The room must be kept clear for at least 2 hours after the patient has left, then fully cleaned and disinfected before being used by any other staff or patient

·         If you work in a clinic that does NOT have fit tested N95s available or negative pressure rooms, consult management to develop safety protocols for reducing risk of exposure. This can include measures such as:

o   Phone screening any patients with suspected symptoms through HealthLink prior to them being seen in office. If their risk of measles is thought to be low, consult with your health team on the most appropriate course of action

o   If patients with suspect symptoms presents to your clinic:

Immediately have them don a medical mask and take them to a private room

Call you medical officer of health (MOH) for direction on care coordination for the patient


 

Sources and Resources for more information:

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