With March break just days away, New Brunswick’s acting chief medical officer of health is urging people to make sure they’re fully immunized against measles before travelling outside the country.
Dr. Yves Léger says a global surge in measles cases, due in part to a decline in vaccinations during the COVID-19 pandemic, has him worried about the potential for travel-related cases in the province.
“Diseases that happen in other countries pose a risk to us as well, because people can easily go to other countries, pick up those infections and can be back here in New Brunswick and be contagious in a very short period of time,” Léger said Wednesday.
Measles is a highly contagious disease that can cause serious illness and severe complications, including deafness, brain damage and even death.
The virus is transmitted through the air when an infected person breathes, coughs, sneezes or talks, or by direct contact with infected nasal or throat secretions.
New Brunswick’s last incidence of measles — an outbreak in Saint John in 2019 that resulted in 12 cases — started through international travel. A person who had recently travelled to Europe became the pr
Travelling for March break? N.B’s top doctor wants you immunized against measles
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Dr. Yves Léger is on alert after Canada’s chief public health officer voiced concern ahead of a busy time for international travel. Canada now has six known measles cases, although the disease is considered eliminated in this country.
ovince’s first confirmed case of measles since 2017.
Public Health prepares for potential case
“In light of the situation that’s happening across the globe, we’ve already started to beef up our preparations in anticipation of a potential case,” said Léger. “Hopefully, there won’t be, but we certainly would rather be prepared if that’s the case.”
Public Health officials have been reviewing their guidelines for how they manage measles cases, as well as contacts, to ensure they’re up to date, he said.
WATCH | Top doc urges immunization to prevent measles spread:
They’ve also worked with the communications branch to increase social media posts about measles and to try to encourage people to ensure they’re up to date with their vaccines, especially if they’re travelling.
In addition, they intend to distribute a memo to health-care practitioners soon to raise their awareness, make sure they’re keeping an eye out for any potential cases, and encouraging vaccines with their patients.
“It’s always better to prevent than to try and treat or to manage … outbreaks,” Léger said.
His comments echo a warning issued by Canada’s chief medical officer of health last Friday. Dr. Theresa Tam urged people to ensure their measles vaccinations are up to date before any international travel.
“As we head into the spring break travel season, I am concerned that the global surge in measles activity, combined with the decline in measles vaccine coverage among school-aged children in Canada, could lead to an increase in imported measles cases, potentially resulting in transmission in communities in Canada,” she said in a statement.
Although measles has been considered eliminated in Canada since 1998, meaning the disease is no longer constantly present, cases can still occur when people who are not fully vaccinated travel to or from a country where the virus is circulating. These imported cases can lead to subsequent spread of measles in Canada among unvaccinated or under-vaccinated people, Tam advised.
6 confirmed cases in Canada
As of Friday, the Public Health Agency of Canada was aware of six measles cases in Canada, “most” of which involve unvaccinated or under-vaccinated children who travelled internationally. Some cases have required hospitalization.
More than 90 per cent of people who are not immune to measles and who come into contact with the virus will become infected, according to Tam.
Children under five, adults older than 20, pregnant people and people who are immunocompromised are at higher risk of complications.
Not too late
Ideally, the measles vaccine should be administered at least two weeks before travel, said Léger.
But it can still provide benefits if your departure is sooner, he said.
“Your body will still start to produce some immunity during that time and will hopefully provide some protection even though it’s not complete protection.”
Dr. Yves Léger, the province’s acting chief medical officer of health, said because measles is so highly contagious, any decrease in vaccination rates ‘opens up the door for measles cases to take hold and to spread.’ (Government of New Brunswick/Zoom)
Since October 1995, all children born in New Brunswick have been offered two free doses of the measles, mumps, rubella and varicella (chicken pox), or MMR, vaccine, at 12 months and 18 months of age.
Together, the doses are almost 100 per cent effective at preventing infection, according to health officials.
Nearly 92 per cent of New Brunswick students entering school in 2022-23 were immunized, the Department of Health has said.
Two doses of the measles vaccine are nearly 100 per cent effective at preventing infection, according to health officials. (Damian Dovarganes/The Associated Press)
Léger described the vaccination rate as “pretty good,” but would like to see it higher.
“It’s not quite meeting the national target” of 95 per cent to be able to prevent cases from spreading, he said.
People born in 1970 or later who have not received two doses of MMRV vaccine should contact their health-care provider to be immunized.
Adults born before 1970 are generally considered immune to measles, through previous exposure to the virus.
The Canadian Immunization Guide recommends that adults who don’t know whether they received two shots get a booster, especially if they’re travelling.
Symptoms to watch for
People who do travel outside the country are encouraged to monitor for measles symptoms for the first couple of weeks.
Measles typically starts with cold-like symptoms, such as a fever, runny nose, cough and red, watery or sore eyes, said Léger. Tiny white spots may appear on the inside of the mouth two to three days after symptoms begin.
A red blotchy rash also usually appears on the face within three to seven days, then spreads to the rest of the body.
About three to seven days after measles symptoms begin, the tell-tale rash that looks like small red spots appears. It usually starts on the head and neck and spreads down the body, arms and legs, the Department of Health said. (U.S. Centers for Disease Control and Prevention)
Anyone who suspects they have symptoms should get checked out immediately, said Department of Health spokesperson Katelin Dean.
They should wear a mask, and immediately inform their health-care provider of their recent travel, she said in an emailed statement.
Most people are sick for up to 10 days and then recover completely.
How the 2019 outbreak unfolded
The first confirmed case of the 2019 outbreak was announced on April 26, but the infected person had visited the Saint John Regional Hospital’s emergency room before being diagnosed and potentially exposed more than 2,000 people to the virus.
The second case, confirmed on May 13, wasrelated to the first. A person from Kennebecasis Valley High School in Quispamsis was in the emergency room at the same time as the European traveller, and the potential exposures multiplied.
About 460 teachers from Rothesay, Quispamsis, Belleisle and Hampton had attended the local branch meeting of the New Brunswick Teachers’ Association at KVHS just days before that person was diagnosed. They were invited to attend a special vaccination clinic at the school.
Before the month was over, 10 more cases were confirmed, eight linked to KVHS.
Two other schools in the Kennebecasis Valley — Harry Miller Middle School and Rothesay Park School — decided tocancel their Grade 8 trips to Quebec because of the long incubation period of the virus.
The Health Department set up a dedicated phone line to help people check their immunization records.
Public Health started reserving its vaccine supply for those considered most at risk — infants and people who had direct contact with somebody with measles.
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.
