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Can you get measles if vaccinated? What to know as cases rise

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As measles cases continue to rise in Canada, last week brought an uncommon occurrence.

A fully-vaccinated 30-year-old teacher in Ontario contracted the highly contagious infectious disease. This event has drawn the attention of health officials, highlighting its rarity.

The man had close contact with students and teachers at a high school in the York Region, north of Toronto, and the case was likely related to community transmission, the region’s medical health officer said on Monday.

Although fully-vaccinated people can get measles, Dr. Sumontra Chakrabarti, an infectious diseases physician at Trillium Health Partners, stressed how infrequent it is.

“This vaccine is very good at preventing infection, but it’s not 100 per cent. It’s about 95- to 97-per cent effective,” he said.

“So there are going to be people who are fully vaccinated that still might get measles. It still does protect you against the more severe aspects of it.”

This particular case adds to the 17 reported instances of measles across Quebec, Ontario, Saskatchewan, and British Columbia as of Monday. More than half of these cases have been concentrated in the Montreal area.

Measles is one of the most contagious diseases in the world and is airborne. It is so contagious, Chakrabarti said if someone with measles exits a room, others can be infected up to two hours after that person has left.

“The best protection that you have is the vaccination by far,” he stressed. “(The measles) is an exceptionally, if not the most, contagious virus that we know in terms of identified human pathogens. If you don’t want to get infected, you should avoid crowded indoor spaces. But apart from that, it’s something that’s very, very difficult to avoid.”

 

About the measles vaccine

The measles vaccine is available in Canada as measles-mumps-rubella (MMR) or measles-mumps-rubella-varicella (MMRV) vaccine.

Since its approval in Canada in 1963, the vaccine has led to a decrease of more than 99 per cent in measles cases, according to the federal government.


Number and incidence rates (per 100,000 population) of reported measles cases in Canada by year, 1924 to 2023.


Health Canada

The efficacy of a single dose of the measles vaccine given at 12 or 15 months of age is estimated to be between 85 and 95 per cent. Health Canada states that with a second dose, efficacy is nearly 100 per cent.

The disease was declared eradicated in Canada in 1988 following an extensive immunization campaign. However, in recent years, it has resurfaced due to a decline in vaccination rates, according to Health Canada. Most cases come from abroad, brought into the country by travellers who are not vaccinated or under-immunized.

The risk of measles spreading is heightened where there are a lot of unvaccinated or non-immune people clustered together in regions or communities. And while measles vaccination rates are high in Canada, Health Canada said they are still below “the necessary threshold for community immunity in some places.”

The target vaccination coverage for measles is 95 per cent, according to Health Canada.

The 2021 Childhood National Immunization Coverage Survey shows that 91.6 per cent of two-year-olds in Canada have received at least one dose of a vaccine.

“The target vaccination for measles in the community would be 100 per cent, that would be my dream,” Chakrabarti said. “But when you start to get anywhere above 95 per cent to 97-per cent coverage, that’s when you have an excellent wall of protection.”

 

Who should get the measles vaccine?

The measles vaccine is recommended for anyone over the age of one. The vaccine is administered as a two-shot series, with the first shot given at around 12 to 15 months of age. The second shot is given at 18 months or between ages five and six years (before your child starts school), according to the Canadian Pediatric Society.

Infants under the age of one could potentially receive the measles vaccine and Chakrabarti recommended parents consult with their health-care provider for guidance.

Although the measles vaccine was initially available in the 1960s, in 1971, it was combined with the mumps and rubella vaccines to create the three-in-one MMR shot.

Adults born before 1970 can be “presumed to have acquired natural immunity to measles,” according to Health Canada, and only one dose is recommended.

“Before the 1970s, most people would have been infected with measles, and so that infection provides them with a level of immunity,” explained Matthew Miller, the director of the Degroote Institute for Infectious Disease Research at McMaster University.

“That is why they really need one dose of the vaccine to boost that immunity and give them really strong additional protection,” he said.

For adults born after the 1970s, two doses are recommended.

Chakrabarti said if you are unsure how many measles shots you received, there are a few ways to find out.

The first option is to visit your family physician, who may already have your vaccination record on file. If your record isn’t available, Chakrabarti reassured that there’s no harm in receiving an additional dose.

“If you already had two doses and you get a third one, it’s not going to be harmful. But if you’ve only gotten one dose, it certainly can help,” he said.

Health-care providers also offer blood tests to verify vaccination status, he added.

 

What happens if you get the measles?

Miller and Chakrabarti underscored that vaccination remains the most effective defence against measles.

If you’re vaccinated and contract measles, the symptoms are typically milder.

“The reasons that happen sometimes has to do more with an individual’s health status than with how good the vaccine is,” Miller said. “There are people who may have sort of undetected immunological deficiencies at the time that they become vaccinated. And so that vaccine just doesn’t work as well in those types of individuals, which can lead them more susceptible to infection.”

However, Miller cautions that without immunization, you face a higher risk of severe complications and spreading the disease to others.

“One of the things that people don’t recognize, because most people would not have experienced measles in the recent past, is how severe measles can be for children who do become infected. It’s not something to be trivialized,” Miller said.

When you become infected with the measles virus, you may experience a range of symptoms. Initially, you might have a high fever, cough, runny nose, and red, watery eyes. After a few days, a characteristic rash typically develops, starting on the face and spreading to the rest of the body.

But measles can also lead to severe consequences, especially in children.

This includes cases of “bad viral pneumonia, brain inflammation, deafness, and a very scary thing called SSP, where a young child can get measles and completely recover from it,” Chakrabarti explained. “But then in the next 10, 15 years, they all of a sudden get a decline in their cognitive function to the point that they’re in a vegetative state.”

He added that while measles cases are on the rise in Canada, this trend has occurred in the past, so it’s not unprecedented. He emphasized that vaccines have proven highly effective in halting the spread of measles previously.

— with files from the Canadian Press

 

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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