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diagnosed with measles: managing isolation, care and prevention
5 minute read
going to a walk-in clinic is out of the question, and since as many as 6.5 million canadians do not have a family doctor, it’s essential to know who to call.
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measles, a highly contagious virus that can affect the respiratory system, was declared eliminated from canada in 1998. now, with new cases rising in various provinces, many people are left to wonder what they should do if they happen to contract the previously eradicated infection.
the symptoms of measles, including an initial fever followed by a red, blotchy rash, cough, and watery eyes, are nonspecific, making it difficult to distinguish between a regular cold and other viral infections until the rash appears.
many canadians born after 1970 are protected against measles due to the two-dose vaccine regimen introduced at the time.
dr. christine palmay, a family physician based in toronto, ontario, notes that the covid-19 pandemic contributed to the lower vaccine rates of today. because people were told to isolate and stay home, regular vaccine schedules and access to that form of healthcare were all but eliminated during the pandemic.
“that set the stage for a perfect storm when we’re coming out of the plague, everybody’s tired, the healthcare system’s taxed, and we have to not only deal with chronic diseases and all the aftermath while still dealing with covid. we have to catch up, and that, unfortunately, is not happening as quickly as we would want.”
lower vaccination rates are also caused by hesitancy due to misinformation, leading to fewer protected individuals and a threat to herd immunity. because of this, knowing how to navigate the system if you or your child do contract measles will ensure that you get the care you need to avoid complications that, in rare cases, could be deadly while also avoiding spreading the infection to others.
practice isolation as a first step
if you suspect but aren’t yet sure that you or your child has measles, it’s crucial to stay home and isolate. being around other people or going to the doctors to get a proper diagnosis will only put others at risk. instead, it’s essential to call your doctor or a public health unit to get advice on how to isolate properly, as well as the following steps to ensure that you or your child are cared for.
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according to dr. palmay, isolation means being away from everybody else in the household as well as the public. but it’s not always that easy.
“in theory, much like covid, that one person needs to be alone in a room. (but) are you going to send a one-year-old alone to a room?” she said.
in that case, all you can do is avoid others as best you can, especially those who belong to high-risk populations, while protecting yourself by wearing a mask and practicing good illness-preventing hygiene.
“avoid contact with pregnant patients, infants under 12 who have never been immunized, and anybody with an immunocompromised condition,” she said. “so, if you’re stratifying risk, for example, if your grandfather has unrelenting disease, he’s doing chemotherapy, you’re not visiting.”
once you’ve spoken to public health or your primary care physician, they will be able to let you know whether or not you need to go to a health centre equipped for handling measles infections, or if you can practice a watchful waiting approach.
isolation also involves knowing your or your child’s risk score regarding transmission. some people may be more contagious than others, depending on when they first contracted the virus.
“people with measles are considered infectious from four days prior to the onset of the rash to four days after, about nine days in total,” she said. “(but) if you’re immunocompromised, it may be longer.”
only go to healthcare facilities equipped to handle the measles
going to a walk-in clinic is out of the question, and since as many as 6.5 million canadians do not have a family doctor, it’s essential to know who to call. your local public health unit is a good starting point, but dr. palmay notes that the correct contact for information and next steps depends on the individual.
“pediatric clinics generally have responses that are set up for these types of cases,” she said. “you can call that 411 health info line to get some advice.”
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many community physicians are not well-equipped to handle measles because they lack the necessary infrastructure to support isolated care. for example, many community health centres are located in buildings that house other businesses, or lab centres and diagnostic services. people with measles can’t just go into the same building because it puts everyone else at risk, and those places may not have what is required to test or offer treatment.
dr. palmay notes that her practice is one of those places that isn’t set up to handle measles infections.
“it was not part of our routine management. we’re now somewhat prepared, but i am a sole practitioner in the community. i don’t have a negative pressure isolation room. certainly, we would clean the room and things like that, but trying to fit in a patient before and after hours, the logistics are almost impossible from my clinic.”
finding the right care
once you become aware of the diagnosis, and are isolating from others, it’s time to focus on care for yourself or your child. this aspect of managing the measles is especially vital for younger individuals or those in high-risk populations because, in rare cases, the viral infection can lead to life-threatening complications.
at first, you can watch the infection like you would any other, ensuring that you or your child is getting adequate fluids to avoid dehydration, managing fever, and getting enough rest. since there is no single medication used to treat measles, the body must be well-taken care of while it fights off the virus.
you should also be watching for complications during this time so that you know if you or your child requires hospitalization.
“if your child’s not drinking throughout, if they’re not responsive, if they’re having problems breathing, and can’t hold down food because of diarrhea … that’s a child that needs some attention,” she said.
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abnormal behaviours or becoming unresponsive are also signs that you or your child require more in-depth care for measles.
at that point, it’s time for another phone call to a healthcare provider or information service to get advice on when to go to the hospital, as well as how you should prepare to avoid spreading the virus to others who are there for different ailments.
“just be very careful,” she said. “watch for signs of decomposition because this virus can kill.”
prevention is the best tool to combat measles
if you or your child contracts the measles virus but have not been vaccinated, you do not need to get the vaccine after you’ve made a full recovery. at that point, you will have lifelong immunity to the disease.
however, for those who have not yet received the vaccination, it is an effective way to prevent contracting it from others.
for parents who are wary, dr. palmay notes that finding information using reputable sources and educating oneself on what the vaccine is, its potential downsides versus the benefits, and how it protects against measles and measles complications can put their minds at ease.
“don’t underestimate the power of preventative care,” she said. “good medicine treats disease, excellent medicine prevents it.”
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