From the Office of the Provincial Health Officer: Advisory on measles diagnosis and reporting

​​This message is being shared by BCCNM on behalf of the Office of the Provincial Health Officer, Ministry of Health.

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• ​There has been a recent resurgence of measles activity in Canada, the United States, and Europe. There is ongoing risk of importation and spread, particularly among unvaccinated populations in B.C.
• Northern Health Authority is responding to multiple lab-confirmed measles cases in Northeastern B.C. near Fort St. John. Multiple other health authorities have also reported measles cases.
• Measles is a reportable disease, and clinicians are required to report to the Regional Health Authority Communicable Disease (CD) Unit confirmed cases and those for whom clinical suspicion for measles is high based on susceptibility, exposure history, and symptoms. 
• Clinicians are urged to review and update patients' measles vaccines at every opportunity, particularly at this time of heightened measles activity in British Columbia.
• Clinicians are also urged to ensure they themselves are protected against measles.
• People are considered immune to measles if they:
• Have 2 doses of measles-containing vaccine
• Were born before 1970 (1957 for health-care workers) – those born before these dates are considered immune through natural infection with measles, those born after these dates require 2 doses of measles-containing vaccine to be immune.
• Have lab evidence of immunity (see note below about the role of serology)
  

Testing for measles

• Consider a measles diagnosis in patients presenting with a febrile rash illness and other clinically compatible symptoms (cough, coryza, conjunctivitis), in the setting of potential exposure or travel to an area of high measles prevalence, and particularly in the absence of measles immunity.
• A nasopharyngeal or throat/nose swab for NAT/PCR is the preferred method for measles diagnosis, ideally within 7 days of rash onset. A urine sample for PCR can also be submitted within 14 days of rash onset.
• Measles serology testing should not be routinely performed to confirm immunity. In cases where immunization records are not available and immunity is unknown, immunization with a measles-containing vaccine is preferred.​