'National embarrassment': Canada is no longer a country that has eliminated measles
Canada no longer can claim it has eliminated the most infectious virus known to medicine after the Pan American Health Organization announced Monday it has revoked the country’s measles elimination status.
The decision comes after Canada failed to contain spread of the same viral strain of measles for more than one year.
“While transmission has slowed recently, the outbreak has persisted over 12 months, primarily within under-vaccinated communities,” the Public Health Agency of Canada said in a statement Monday.
“Canada can re-establish its measles elimination status once transmission of the measles strain associated with the current outbreak is interrupted for at least 12 months,” it added.
The country has been at the centre of a large, multi-jurisdictional outbreak that began in October 2024, with a total of 5,138 cases reported as of October 25 — more than twice as many recorded in the past 25 years combined.
Two deaths have been reported, one from Alberta, the other from Ontario, in babies born prematurely after their mothers contracted measles while pregnant. At least 375 people have been hospitalized. Among those infected, 88 per cent were unvaccinated; two per cent had one dose of the two-dose vaccine, five per cent had two or more doses. The vaccine status was unknown for the remaining five per cent.
Canada had held its measles elimination status since 1998, though cases continued to occur sporadically, mostly involving travel to regions where measles is circulating.
From 1998 to 2024, there were an average of 91 measles cases reported in Canada each year, with between zero and 752 cases reported annually.
Earlier this month, a special committee of PAHO met to review Canada’s measles status in the wake of an outbreak traced to an infected traveller who attended a Mennonite wedding in New Brunswick last fall.
Cases spread to nine other provinces and the Northwest Territories.
While the decision to strip Canada of is measles elimination status “doesn’t change the average Canadian’s day-to-day life, what it does mean is that one of the most debilitating and deadly childhood infections is present in our lives again,” McMaster University immunologist Dawn Bowdish said.
“Measles is one of the few infections we should have been able to eradicate entirely, so to have it circulating in Canada is an indicator of how strained our public health and tracking systems have been,” Bowdish said.
“It should be a national embarrassment to join a list of countries whose public health systems have been torn apart by war or civil unrest, but the more immediate tragedy is that we will see more lost pregnancies, more premature babies and more children who won’t ever grow to their full potential due to the terrible and short and long-term effects of measles.”
Other infectious diseases may once again take a foothold in Canada, Bowdish added.
“The vaccine for measles also includes vaccines for rubella and mumps. Measles is the most contagious so it makes sense that outbreaks for measles started first, but rubella — a major cause of birth defects — and mumps, a cause of infertility, will come next unless we make changes.”
Unlike other respiratory infections that infect the lungs or airways, measles infects and kills immune cells, making people vulnerable to bacterial infections, on top of measles, months or years afterwards that can lead to serious complications, Bowdish said.
It also survives well in the air. “Some viruses dry out and die. Influenza is one of them. Measles is not,” Bowdish said. In one reported case, a child with measles got off a plane at Chicago’s airport “and an unvaccinated person three gates down contracted measles.”
“If you had a young baby who was too young to be vaccinated, you might think twice about bringing them to a major event, or to somewhere there’s going to be a lot of people,” she said. “It’s a degree of worry we shouldn’t have to have in this country anymore.”
Vaccination rates have dropped below the threshold needed for herd immunity to prevent infection with measles, considered one of the most, if not the most transmissible airborne viruses affecting humans. An infected person can infect up to 18 others who are unvaccinated, under-vaccinated or aren’t immune due to past exposure to the virus.
“Thanks to vaccines, many people have never seen an outbreak in their lifetime, but measles can cause severe complications such as blindness, pneumonia, encephalitis and even death,” PAHO director Dr. Jarbas Barbosa told reporters.
Stopping the spread of measles requires that at least 95 per cent of the population is vaccinated with two doses of the vaccine throughout “cities, municipalities and city blocks,” and across all communities “without exception,” Barbosa said.
It’s recommended that kids receive two doses by age seven.
However, between 2019 and 2023, among seven-year-olds, two-dose measles vaccine coverage dropped from 86.3 per cent to 75.6 per cent, one Canadian study found.
Bowdish puts the drop down to several factors, including a lack of public health and outreach “to those pockets and communities that have allowed distrust in vaccines and the lack of vaccination to increase,” the family doctor crisis (pharmacies can’t give childhood vaccinations) and, to a lesser extent, vaccine misinformation. “It’s a small fraction of a bigger problem — the bigger issues are all these other systems issues.”
“Any public health person will tell you public health is best administered by the people of a community, to their community,” Bowdish said.
“You need people who are embedded and trusted in these communities — not people to come in from Toronto one day and tell everyone to get vaccinated and then leave again. You don’t build trust that way.”
When one country loses measles elimination status, the whole Americas region loses it, Barbosa said. However, “It’s important to say that all the other 34 countries in the region keep their certification as measles-free,” he said.
National Post
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