Measles: Global Update
Updated: July 28, 2016
Travel Health Notice
Measles is a highly contagious viral disease. It is one of the leading causes of death in young children worldwide. Measles cases occur around the world.
Within the last 10 years, the number of measles cases reported globally has decreased significantly; however, there have been a number of large outbreaks, mostly in Africa and Europe. The Region of the Americas, including Canada and the United States, have experienced outbreaks of measles, when the virus has been imported from other regions.
Travellers who are not immune to measles (those who have not been fully vaccinated or have not been previously infected with the disease) have an increased risk of infection. For example, travel through international airports, including those in Canada, may increase your chance of exposure to the measles virus.
The Public Health Agency of Canada reminds travellers to make sure their measles vaccination is up-to-date.
Where is measles a concern?
Measles remains a common disease worldwide. In many regions of the world including Africa, Asia, Europe and Oceania, measles is present (endemic) and large outbreaks can occur. Travellers who are not immune are at risk. A map of reported measles cases worldwide is available on the World Health Organization (WHO) website.
- China: In 2015, more than 42,000 cases of measles were confirmed in China. Cases of measles have been reported in travellers who arrived in Canada from China.
- India: In 2015, over 83,000 cases of measles were confirmed in India. To date in 2016, there are already over 38,000 confirmed cases of measles. Since 2010, 11 cases of measles have been reported in travellers who arrived in Canada from India, with the most recent case reported in March 2016.
- Mongolia: In 2014, Mongolia was declared measles-free. An outbreak of measles has been reported in 2016 with over 23,000 confirmed and suspected cases of measles. Deaths are reported mostly in infants up to 8 months of age.
- Pakistan: Measles is present (endemic) in Pakistan, and there have been reported cases of measles among travellers who arrived in Canada from Pakistan. In 2016, all reported importations have been young children, most of whom were too young to be immunized.
- Nigeria and Sierra Leone: Ongoing measles outbreaks are being reported in both of these countries.
In Canada, measles has been eliminated since 1998. However, Canada will continue to see measles cases related to travel to countries where measles is present (endemic) or where there are large outbreaks.
Recommendations
Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.
1. Get vaccinated
Canadians are reminded to keep all vaccinations up-to-date. See the recommended routine vaccine schedule for further information.
Travellers should be up-to-date on measles immunization regardless of their travel destination.
- Infants (6 months to 12 months):
- During outbreaks or for travel to regions where measles is a concern, the vaccine may be given as early as six months of age. Under these circumstances, the routine two dose series must be then restarted on or after the first birthday, for a total of three doses.
- Children/adolescents (12 months to 17 years of age):
- Two doses of a measles-containing vaccine are recommended for children.
- The first dose should be given at 12-15 months of age and the second dose should be given at 18 months of age or any time thereafter, typically before school entry.
- Adults (18 years of age and older):
- Adults born in or after 1970 should make sure that they have received two doses of measles-containing vaccine.
- Travellers born before 1970 should receive one dose of measles containing vaccine if they do not have one of the following:
- documented evidence of receiving measles-containing vaccine on or after their first birthday;
- laboratory evidence of immunity (e.g. through blood testing); or
- a history of laboratory confirmed measles disease.
- Wash your hands with soap under warm running water for at least 20 seconds, as often as possible.
- Use alcohol-based hand sanitizer if soap and water are not available. It's a good idea to always keep some with you when you travel.
3. Practise proper cough and sneeze etiquette
- Cover your mouth and nose with your arm to reduce the spread of germs.
- If you use a tissue, dispose of it as soon as possible and wash your hands afterwards.
4. Monitor your health
- If you develop symptoms similar to measles when travelling or after your return to Canada, you should see a health care provider:
- Describe your symptoms to the health care provider before your appointment, so that he/she can arrange to see you without exposing others to measles. It is best to avoid close contact with other people for four days after the rash first appears to reduce the spread to others who may not be vaccinated.
- Remember to tell the health care provider which countries you have travelled to.
- If you are still ill upon arrival into Canada, please tell the flight attendant before you land or the border services officer as you exit the flight.