While most of Canada’s current measles case have been linked to international travel, some in Quebec and one in Ontario have not, meaning the virus is being transmitted in communities.Eric Risberg/The Associated Press
The discovery of measles cases in several provinces is prompting public health officials to recommend Canadians check their vaccination status before travelling abroad.
Ten cases of measles have been confirmed in the Greater Montreal area over the past few weeks, while five cases have been reported in Ontario, and at least one in both B.C. and Saskatchewan.
While most of the cases have been linked to international travel, some in Quebec and one in Ontario have not, meaning the virus is being transmitted in communities.
The measles virus is airborne and highly communicable, with symptoms that at first mimic those of a cold or flu: fever, cough, runny nose and red, watery eyes. Around two to three days after symptoms begin, small white spots may appear inside the mouth and throat. Around three to seven days later, a rash develops on the face and spreads down the body, arms and legs. The incubation period is around 10 days, and those infected are contagious from four days prior to a rash appearing and four days after.
The virus can lead to serious complications, including pneumonia and respiratory failure. According to the Public Health Agency of Canada. about one in 1,000 people infected with measles will develop encephalitis, or brain inflammation, which can cause deafness, blindness and development disability in children.
One to three out of every 1,000 people with measles will die as a result of the disease.
Canada’s Chief Public Health Officer, Theresa Tam, has strongly advised Canadians to get vaccinated with two doses of the measles vaccine, especially before travelling. In 1998, measles was declared eliminated in Canada, meaning cases were no longer originating in this country. But this year, more than a dozen cases have been reported. In 2023, only 12 cases were reported for the entire year.
Preventing the spread of measles within a community requires 95 per cent of the population to be vaccinated. But measles vaccination coverage has dropped below that mark in the country, partly because of the disruption to routine childhood immunizations during the COVID-19 pandemic, Canada’s public health agency said.
Here’s what to know about checking your vaccine history and where to get a dose if needed.
How many doses of the vaccine should people get?
Both measles, mumps and rubella (MMR) and measles, mumps, rubella and varicella (MMRV) vaccines are available. The efficacy of a single dose given at 12 or 15 months of age is estimated to be 85 to 95 per cent. With a second dose, it’s nearly 100 per cent effective.
Unlike COVID-19 or the flu, the measles virus is stable and does not mutate. This means that people who had two doses as a child are still immune today, and people who have recovered from measles have permanent immunity.
Infants
Babies are one of the highest risk groups for measles and aren’t eligible for the vaccine until their first birthday. But infants who are six months to 11 months can get a dose of the MMR vaccine if they are travelling to an area with measles spread. Public health experts say caregivers should speak to a health professional to determine eligibility.
Children
Two doses of the vaccine are recommended for routine childhood immunization. The first dose of either MMR or MMRV vaccine should be administered at 12 to 15 months of age, and the second dose at 18 months of age or any time before starting school (around four to six years old).
If a child or adolescent who is younger than 18 years old misses the routine vaccinations, they should receive two doses of the vaccine, administered at least four weeks apart.
Adults born after 1970
Adults born in or after 1970 should receive one dose of the vaccine.However, if travelling abroad, Canada’s public health agency recommends this age group receive a total of two doses. People who are pregnant should not get the MMR or MMRV vaccines because of the theoretical risk to the fetus.
Adults born before 1970
These adults can be presumed to have acquired natural immunity to measles because they likely were infected while the disease was endemic in Canada. If you know you did not have measles orhave not been immunized and are travelling internationally, you can get one dose of the vaccine. The World Health Organization issued an alert in December about what it described as an “alarming” rise in measles cases in Europe.
Adults with greater risk of exposure
All adults who are at a greater risk of measles exposure – such as health care workers and military personnel – are recommended to get two doses of the MMR vaccines.
How to check your or your child’s vaccination records:
To obtain your vaccination records, contact your family doctor or any previous primary health care providers. You can also contact your local public health authority.
Where can I get a vaccine?
You can get the MMR or MMRV vaccine from your family doctor, provincial public health units or offices, and some pharmacies, depending on the province. Pharmacies in British Columbia, New Brunswick and Newfoundland currently offer the measles vaccine for adults and children four years and older.
I can’t find my vaccine records. What now?
Canada’s public health agency says that if you don’t remember whether you received a second dose, or if there’s any doubt, talk to a health care provider about getting a booster shot.
There is no harm in getting another dose of MMR vaccine even if it turns out you did have two shots, said Shelly Bolotin, director of the Centre for Vaccine Preventable Diseases at the University of Toronto’s Dalla Lana School of Public Health. “There’s no relationship between adverse events and more doses that you have. It’s a very, very, very safe vaccine.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
