Measles: Spotting Signs of Infection in the Mouth
According to the Public Health Agency of Canada’s weekly Measles and Rubella Reports, there are presently five active cases of measles in Canada with a total of eight having been reported in 2019. A number of confirmed cases of measles were reported in mid-February in British Columbia. Most of these cases were associated with a cluster of related school-based outbreaks in Vancouver linked to importation from outside of North America.
Measles is a highly contagious and serious disease with no antiviral treatment. Measles is highly contagious because transmission is airborne causing it to infect 90% of contacts unless the contact is vaccinated. It can cause can cause encephalitis and pneumonitis and results in 1-3 deaths out of every 1,000 infections.
An infected child or adult visiting your practice can incubate the virus and infect others nearby who are not immune.
Are Measles Making a Comeback?
Some of the First Signs and Symptoms Appear in the Mouth
Most parents and even some pediatricians and physicians have never seen or treated measles before, making it difficult for them to recognize signs and symptoms. This lack of experience and familiarity also means parents and caregivers underestimate the severity of the disease, are more likely to consider their child to be at a low risk, and may not appreciate how easy it is for measles outbreaks to occur.
Early signs of infection can be seen orally in some including blue-grey Kolpik spots on the soft palate and oropharynx, and bright red spots on the buccal mucosa resembling grains of sand.
For up to four days before these symptoms appear, an infected person will feel normal. They are highly infectious at this time and will remain infectious for up to four additional days after symptoms appear.
Other signs and symptoms of measles include a non-itchy macular-papular skin rash, fever, cold-like symptoms, and light sensitivity.
What is Causing New Cases?
Health professionals know that measles is effectively prevented by the measles, mumps, rubella (MMR) vaccine.
While endemic transmission was declared to be eliminated in the United States and the Americas in 2000, measles is now making a comeback due to three factors.
When less than 90% to 95% of the population has immunization, the community loses its protection putting people who cannot receive the vaccine like those with, cancer, congenital immune deficiencies, transplants, at risk (these conditions do not respond to vaccination). While some are not vaccinated due to pre-existing health conditions, limited access to health care in their home country prior to immigration, most children are not vaccinated because their parents have “vaccine hesitancy” and lack confidence in the safety and efficacy of vaccines despite scientific evidence.
Managing Measles in the Dental Office
Talking to Patients About Measles and Vaccinations