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canada at risk of measles outbreak, as cases rise, expert warns

canada and many countries eliminated the highly contagious disease as a result of mass-immunization campaigns, although it has remained endemic in parts of the world

by elizabeth payne

jan 9 2020
read time 4 minute read
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canada at risk of measles outbreak, as cases rise, expert warns
canada's rate of immunization against measles is around 90 per cent for seven year olds. public health officials want to see coverage rates of 95 per cent to thwart the spread of the highly infectious disease. joe raedle / getty images
canada is not immune to the kind of measles outbreaks alarming health officials around the globe, an ottawa pediatric infectious disease expert is warning.
dr. anne pham-huy, an infectious disease physician at cheo and member of the national advisory committee on immunization, said less-than-optimal immunization rates at a time of dramatically increasing global outbreaks means canada, like other countries, is at risk.
pham-huy made the comments as canada is on track to have a serious year for measles, with 111 cases since january, compared with 29 cases in all of 2018. there were 19 new cases during one week in august alone.
canada and many countries eliminated the highly contagious disease as a result of mass-immunization campaigns, although it has remained endemic in parts of the world. but, as a result of vaccine refusal and dropping immunization rates in developing countries, some countries are now losing their measles elimination status — the uk among them. france, meanwhile, has among the highest rates of vaccine distrust in the world.
the u.s., which has had more than 1,200 measles cases so far this year, compared with 371 in 2018, now faces the risk of losing its measles elimination status.
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does that predict the direction in which canada is going?
public health agency of canada spokesperson anna madison said the agency does not foresee canada losing its measles elimination status.
“although measles outbreaks have occurred in canada over the years and more recently because of imported cases, sustained transmission of measles within canada has not been observed since canada’s measles elimination status was achieved in 1998.”
the number of cases fluctuates every year, maddison said, as the number of travellers bringing measles into canada varies, depending on where they go, whether they are immunized and the measles activity in other countries.
still, canada’s immunization rates are high, but not high enough when it comes to completely protecting against measles, said pham-huy. canada’s rate of immunization against measles is around 90 per cent for seven year olds, she said, with pockets of higher and lower coverage. public health officials want to see coverage rates of 95 per cent to thwart the spread of the highly infectious disease. that is doubly important at a time when there are so many cases of measles around the world and when global travel is so common.
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as with the u.s., where one measles outbreak is centred in an orthodox jewish community in new york, canada has communities where vaccination rates are low.
in quebec a religious community in lanaudière north of montreal, which discourages vaccination, was the centre of a measles outbreak in 2015. one case was brought to the community after a trip to disneyland in california and it eventually ballooned to 157 people, the bulk of the country’s 196 cases that year.
in 2014, there were even more cases — a total of 418 spread across five provinces. the largest outbreak that year was in a non-immunizing religious community in british columbia.
“we are not immune,” said pham-huy. “there are pockets of communities that are under vaccinated. if you do introduce a case, because of its highly infectious nature, this is the recipe for outbreaks.”
pham-huy said public health officials also worry about vaccine hesitancy in canada. the world health organization named vaccine hesitancy as one of the top threats to global health.
“in general, immunization rates in canada are not at the target, but they are good. however (people who are vaccine hesitant), are a minority, but it seems to be an increasingly vocal group. it is important that families get the right information from the right source.”

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earlier this week, anti-vaxxers protested vocally when toronto public health passed a motion asking the province to mandate vaccinations for all schoolchildren. exemptions for health and other reasons are currently available.
pham-huy sometimes meet with parents who are hesitant about vaccinations.
“the bottom-line message is that the vaccine is safe and it is effective against one of the most contagious infections that exists.”
during the first six months of 2019, there were more measles cases reported worldwide — 364,808 —  than in any year since 2006.
maddison of the public health agency of canada added that it is “concerning to see vaccine-preventable diseases, particularly those as serious and highly contagious as measles, in canada and around the globe.
“a vaccination coverage rate of 95 per cent is needed to prevent outbreaks of the most serious and contagious of vaccine-preventable diseases,” said maddison. “canada continues to fall short of the 95 per cent coverage goals set by the federal and provincial governments. when immunization rates do not meet the levels needed for community immunity, outbreaks of disease such as measles can and have happened.”
the best protection against measles is vaccination with two doses of measles-containing vaccine.”

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epayne@postmedia.com
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