Understanding the Re-emergence of Measles in Canada: Addressing Challenges and Implementing Solutions

Measles, also known as rubeola, has long been recognized as a highly contagious viral illness predominantly affecting children. Historically, concerted efforts worldwide have led to significant strides in controlling and even eliminating measles in certain regions, including the USA. However, recent years have witnessed a concerning resurgence of measles cases globally, including within Canada. This white paper aims to delve into the factors contributing to the re-emergence of measles in Canada, explore the current landscape of measles infections, and propose strategies to mitigate its spread and impact. 

Factors Contributing to the Re-emergence of Measles in Canada: 

Measles resurgence is not confined to a single nation but is part of a broader global trend. Factors such as conflicts, disruptions in routine vaccination programs due to the COVID-19 pandemic, and increasing vaccine hesitancy in various communities have collectively facilitated the resurgence of measles cases worldwide. 

Canada’s interconnectedness with the rest of the world exposes it to imported cases of measles, particularly during periods of increased travel such as the March Break. These imported infections pose a significant risk of local transmission, contributing to the re-emergence of measles within Canadian communities. Despite overall high vaccination coverage in Canada, certain communities experience disparities in vaccine uptake. This leaves pockets of susceptible individuals vulnerable to measles outbreaks, especially when vaccination rates fall below the threshold necessary for herd immunity. 

As of March 15th, 2024, Canada has reported 17 cases of measles and 1 case of congenital rubella syndrome/infection. These numbers, although relatively low compared to historical peaks, signify a concerning trend given the potential for exponential spread in susceptible populations. Moreover, modeling suggests that without intervention, Canada could be on the brink of a major measles outbreak, with the potential for cases to more than double compared to previous years. 

So, what can we do to help prevent the spread? Here are some insights from Calvin Walker, Sr. Infection Control Consultant at IPAC Consulting. 
 
Encouraging vaccination remains paramount in controlling measles outbreaks. Efforts should focus on increasing vaccine uptake among underserved communities and addressing misinformation and vaccine hesitancy through targeted education campaigns.

Enhanced Surveillance and Tracking: Rapid identification and isolation of measles cases are critical in preventing further transmission. Strengthening surveillance systems and bolstering public health efforts to track and isolate cases can help contain outbreaks before they escalate. 

Promotion of Hygiene Practices: In addition to vaccination, promoting hand hygiene, proper cough and sneeze etiquette, and the use of masks can help reduce the transmission of measles and other infectious diseases. This includes regular hand washing, disinfection of high-touch surfaces, and the proper use of masks, especially in crowded settings. 

Community Engagement: Engaging communities in outbreak response efforts fosters trust and cooperation, facilitating the implementation of preventive measures. This involves collaboration with community leaders, healthcare providers, and educators to disseminate accurate information and address concerns. 

The re-emergence of measles in Canada underscores the importance of proactive measures to prevent and control infectious diseases. By addressing the underlying factors contributing to measles resurgence and implementing targeted interventions, we can mitigate the impact of outbreaks and safeguard public health. Through collective action, including vaccination, hygiene promotion, and community engagement, Canada can effectively combat the spread of measles and protect vulnerable populations from preventable illness and its associated complications. 

 
References: 

• Government of Canada. “Measles and Rubella Weekly Monitoring Reports.” 
• CBC News. “Canada heading toward major measles outbreak without vaccine boost, new modelling suggests.”  

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