Guidance on Measles

Public Health Ontario (PHO) reports that ongoing Measles transmission in Ontario is impacting multiple areas of the province. Measles is a serious respiratory infection that is highly contagious. Ontario has been experiencing an increase in cases, especially since February of this year. Dr. Kieran Moore, the province’s Chief Medical Officer of Health, predicts that the outbreak is likely to continue into the summer.

Measles spreads easily among those who aren’t vaccinated and can lead to serious health issues, including pneumonia, respiratory failure, swelling of the brain, and in rare cases, death. Measles can be transmitted by coughing, sneezing or talking, and infectious droplets may stay airborne for about an hour. Transmission can also occur after contacting infected surfaces. Infected individuals are considered contagious from four days before to four days after exhibiting symptoms.

Symptoms

Symptoms typically develop eight to 12 days after exposure and include:

  • High fever
  • A maculopapular rash (flat, red areas [macules] combined with small, raised bumps [papules]) starting on the face and spreading to the rest of the body
  • Cough
  • Runny nose
  • Conjunctivitis (pink eye)

Early oral signs include Koplik spots, tiny blue-gray spots on the buccal mucosa. These are often present as early symptoms and are a distinctive sign for Measles.

PHO is reminding all healthcare providers, including RDHs, to remain vigilant for signs and symptoms of Measles.

Routine Precautions

CDHO’s Infection, Prevention and Control (IPAC) Guidelines require dental offices to have a written policy for managing clients with suspected febrile respiratory infections, rash, and eye infections. Follow CDHO’s IPAC guidelines for disinfecting non-clinical and clinical surfaces for all clients and ensure proper hand hygiene to minimize potential spread.

Clients should be reminded when confirming appointments that if they are ill, they should reschedule. If there is a Measles outbreak in your area, ask all clients when confirming appointments or on arrival at the office whether they have had any contact with a person infected with Measles. Information on areas and dates of exposure to Measles can be found on PHO’s Measles Exposures in Ontario webpage.

A sign should be posted at the office entrance requesting that clients who may be ill identify themselves to the receptionist. The reception area should have 70-90% alcohol-based hand rub and masks available.

The possibility of Measles should be considered in clients presenting with the above signs and symptoms, especially if they have recently traveled or had contact with a known case of Measles. A symptomatic client should either be rescheduled or, in case of emergency, promptly isolated in a room with the door closed and treated using routine practices and additional precautions. The client should be advised to isolate themselves until they can be further evaluated by a physician.

Reporting

If Measles is suspected, your local public health unit must be contacted immediately to report the suspected case. Find your local public health unit.

For more information about the virus and things to consider before initiating dental hygiene care, please visit CDHO’s Knowledge Network. For the latest information on the situation in Ontario, visit PHO’s website.

Resources

Memo from the Chief Medical Officer of Health

FAQs