Health officials in Metro Vancouver say there is a new case of measles and more possible exposures in a variety of public locations across the region, including four SkyTrain stations on the Canada Line.

"Today, we have a total of 10 cases of measles," said Vancouver Coastal Health's Dr. Althea Hayden, adding that the new case is "very clearly associated with the same set of schools" as some of the first nine.

VCH has also identified a number of locations where people may have been exposed to the disease, including:

  • Russel Sean fitness Richmond between 5:30 and 9:30 a.m. on Feb. 15
  • Broadway-City Hall to Langara 49th Avenue stations on the Canada Line between 9 and 11:30 a.m. on Feb. 15
  • The Langara College tech building between 9 a.m. and 4:30 p.m. on Feb. 15
  • Sport Chek at Richmond Centre between 3 and 5:30 p.m. on Feb. 15
  • Starbucks on No. 1 Road and Bayview between 12:30 and 2:30 p.m. on Feb. 17
  • Dave's Fish and Chips in Richmond between 1 and 3:45 p.m. on Feb. 17
  • The Squamish McDonald's between 9:45 and 11:45 a.m. on Feb. 18
  • Scandinave Spa in Whistler between 11 a.m. and 7:15 p.m. on Feb. 18

"There are specific times and dates for each of these locations where you could have been exposed to measles," Hayden said, adding that some exposures may have occurred as recently as in the last three days.

"We're asking people to look at these times and decide whether or not you may have been exposed."

Those who think they may have been exposed should check their vaccination records, Hayden said.

Those born before Jan. 1, 1970 are considered immune to measles, and those born after 1994 have most likely received both doses of the measles, mumps and rubella, or MMR, vaccine, she added.

But those born between those years and those who grew up outside B.C. might have received the first dose of the MMR, but not the second.

If you think you're not immunized or don't have both doses of the MMR vaccine, you should monitor your symptoms for 21 days after the possible exposure.

What are the symptoms?

Measles is highly contagious and spreads through breathing, coughing and sneezing. It can live as long as two hours in an airspace, even after the infected person has left.

The virus can be spread as early as four days before an infected person knows they have the virus.

Initial symptoms include fever, diarrhea, coughing, runny nose, red and watery eyes and tiredness. After a few days, a rash begins, typically starting on the face and spreading across the body.

In rare cases, it can lead to pneumonia, brain damage, blindness, deafness, and even death.

The virus usually lasts seven to 10 days.

Those experiencing the symptoms are asked to stay home to help prevent the spread.

They should visit their doctor, but call first so the office can take precautions to protect others.

VCH announced the most recent measles outbreak in the Lower Mainland on Feb. 13.

Two days later, Hayden confirmed that doctors had identified a total of nine cases this year. Eight of those are associated with schools in the region. The ninth was identified earlier in the year and is not related to the others.

The outbreak has prompted a spike in the number of people looking to get the vaccine and a significant increase in related clinic visits, according to two local health authorities.

Even though there are no reported measles cases in the Fraser Health region, additional staff have been brought in to help cope with the increased volume of calls from people looking for vaccinations. The health authority says the current wait for an appointment is between five to 15 days.

The Vancouver Coastal Health region has also experienced an increase in patients looking for added protection from the highly contagious disease. In downtown Vancouver, the City Centre Urgent Primary Care Centre on Hornby Street has seen 70 adults and children over the span of about a week, and has given out 64 doses of the vaccine.

"I would say we might be giving one or two a week before," said centre medical director Dr. Afshin Khazei. He added when the outbreak was first announced, medical staff saw six infants and 16 adults that evening alone. "We’ve definitely noticed a difference."

While some patients were looking for the recommended second dose of the vaccine after being immunized once in childhood, Khazei said some were also receiving a measles vaccine for the first time.

Six patients who came to the centre received an alternative to the vaccine: a blood product called immune globulin which contains illness-fighting antibodies. Immune globulin is given to people who have been exposed to the disease but cannot receive the shot for a variety of reasons.

"It’s a scarce resource so it’s reserved for patients that really need that," said Khazei.

Health officials are reminding people they can get vaccinations by visiting their family doctor, a walk-in clinic or urgent primary care centre, or a pharmacy for adults or children over five years old. Calling ahead is also recommended.

With files from CTV Vancouver's Kendra Mangione