Measles: Understanding and Preventing this Infectious Disease

Measles is a highly contagious infectious disease caused by a virus from the paramyxovirus family. It manifests through respiratory symptoms and a characteristic skin rash. Although vaccination has considerably reduced its incidence, measles remains a public health concern, particularly due to recent outbreaks observed in several regions, including Quebec.

Resurgence of Measles in Quebec

In recent years, Quebec has observed a resurgence of measles cases. This increase is attributed to several factors, including:

• Decrease in vaccination coverage: Despite public health efforts, some populations remain under-vaccinated.

• International travel: Measles is still endemic in several regions of the world, and travel can introduce the virus into non-immunized populations.

• Spread within communities: Once introduced, the virus can spread rapidly, especially in environments where vaccination coverage is insufficient.

Current Situation

In 2024, Quebec reported a notable increase in measles cases. Public health authorities are actively working to contain this resurgence through vaccination campaigns and awareness measures. It is crucial for parents to have their children vaccinated and for non-immunized adults to receive the MMR vaccine to prevent new outbreaks.

Symptoms and Complications

Measles symptoms generally appear 8 to 10 days after exposure to the virus and include:

• High fever

• Dry cough

• Rhinitis (runny nose)

• Conjunctivitis (red eyes)

• Malaise and irritability

• Koplik spots: small whitish spots specific to the inside of the cheeks, often near the molars, appearing before the rash.

• Skin rash: a red maculopapular rash (small red spots, raised or flat), separated by healthy skin, typically appearing first on the face before spreading to the rest of the body.

Measles complications can be serious, especially in young children, pregnant women, and immunocompromised individuals. They include ear infections, pneumonia, encephalitis (inflammation of the brain) and, in rare cases, death.

Progression and Recovery

Most measles cases progress toward a complete recovery within about ten days, although fatigue may persist longer.

Contagion Period

People with measles are contagious from five days before the appearance of the rash until approximately five days after its appearance. The period of maximum contagion occurs around the time of the rash, making virus transmission particularly easy during this period.

School Exclusion

To limit the spread of measles, affected children must be kept out of school for at least four days after the appearance of the rash.

Treatment

There is no specific antiviral treatment for measles. Care is primarily symptomatic and supportive:

• Rest and hydration: To help the body fight the infection.

• Antipyretics: Such as acetaminophen or ibuprofen to reduce fever and relieve pain.

• Vitamin A: Children with measles may receive vitamin A supplements, as a vitamin A deficiency can worsen the disease.

Prevention

Vaccination is the most effective way to prevent measles. The MMR (Measles-Mumps-Rubella) vaccine is administered in two doses, generally at 12 months and between 4 and 6 years of age. This vaccine is safe and effective, offering long-term protection against the disease.

Differential Diagnosis

It is important to differentiate measles from other diseases with similar symptoms:

• Kawasaki disease

• Scarlet fever

• Toxidermia

• Allergy

• Other viral rashes

Mandatory Reporting

Measles is a reportable disease in Quebec. This means that any suspected or confirmed case must be reported to public health authorities. This measure allows for the monitoring and control of the spread of the disease, particularly during outbreaks.

Conclusion

Measles is a vaccine-preventable disease, but it remains a threat due to declining vaccination coverage and international travel. The recent resurgence of measles in Quebec highlights the importance of maintaining high vaccination coverage and raising public awareness about the risks associated with this disease. Together, by strengthening vaccination efforts and following public health recommendations, we can prevent the spread of measles and protect the health of our community.

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