Question Period Note: Measles in Canada

There has been widespread measles activity in 2019 affecting many countries (notably, the United States, the United Kingdom, and France). The World Health Organization (WHO) reported that in the first quarter of 2019, the number of confirmed cases worldwide rose by 300%.

Measles is relatively rare in Canada due to effective vaccination programs. However, it is important that Canadians continue to be vaccinated against measles given the travel-related risks of infection and spread to unimmunized people.

• The health and safety of Canadians is our Government’s top priority.
• Vaccination is a safe and effective protection against measles.
• Measles is rare in Canada, thanks to vaccination.
• But this is not the case in all countries. Measles outbreaks remind us that travelers may bring the measles virus into Canada and spread it to unimmunized people.
• We will continue to provide Canadians with reliable information about vaccination and promote vaccination to protect Canadians from serious illnesses.

If Pressed:
• While vaccination is not mandatory in Canada, the Government of Canada is committed to vaccination as a safe and effective public health measure that prevents disease and disability.
• Provincial and territorial governments deliver vaccination programs and determine public health requirements in their jurisdictions.

Measles is a highly contagious respiratory tract infection caused by the measles virus. Measles is spread by contact with an infected person through coughing and sneezing. It is a leading cause of death among young children globally.

Measles is a notifiable disease in all provinces and territories (P/Ts). When a healthcare provider diagnoses a case of measles, notification is also made to the respective jurisdictional public health agency. This helps P/Ts implement measles prevention and control strategies as quickly as possible.

There is no specific treatment for measles. Individuals with measles should self-isolate during the infectious period to prevent infecting others. People should talk to their health care provider if they think they have measles.

Measles infections can cause complications including ear infections, pneumonia, encephalitis, seizures, and, rarely, death. Generally, the disease is more severe in children less than five years of age, adults older than 20 years of age, pregnant women and anyone with a compromised immunity system. Measles during pregnancy can result in a higher risk of premature labour and low infant birth weights.

Measles Outbreaks Nationally and Internationally:
As of November 19, 2019, 113 cases of confirmed measles have been reported in Canada in 2019; 48 have been reported by Quebec, of which 34 cases are linked to an outbreak in the Montreal area; 31 cases have been reported by British Columbia, 13 of which were linked to an outbreak in Vancouver; and, 12 cases have been reported by New Brunswick, all of which were linked to an outbreak in the St. John area. The following P/Ts also reported cases of measles in 2019: Ontario (14), Alberta (4), Northwest Territories (2), Saskatchewan (1), and Manitoba (1).

Measles cases were acquired during travel to the following countries: Vietnam, the Philippines, Ukraine, Poland, France, Pakistan, the United States, Cambodia, Thailand, China, Japan, Bangladesh, India, and the United Kingdom.

29 cases of measles were reported in 2018 and 45 cases were reported in 2017.

Currently, no U.S. states are reporting an outbreak.

Since 2016, multiple large scale measles outbreaks have been reported across Europe, with almost all European countries reporting measles cases by 2017. According to the World Health Organization, cases of measles in the European Region hit a record high in 2018.

Mandatory Vaccination in Schools:
Vaccination is not mandatory in Canada; however, some P/Ts may require documentation of vaccination for children to enter public schools.

To date, only Ontario and New Brunswick require proof of vaccination for measles and other vaccine preventable diseases in order to register in public schools.

Federal Role:
The Public Health Agency of Canada (PHAC) works with P/Ts in the management of outbreaks of vaccine-preventable diseases (VPDs) by providing technical advice and assisting with laboratory testing when requested by a P/T. P/Ts and local public health are responsible for delivering public health programs, including vaccination programs and investigation and follow-up of measles cases and outbreaks.

The federal government has a role in regulatory approval of vaccines, vaccine safety, national surveillance for VPDs and adverse events following vaccination, bulk purchasing of vaccines, national leadership and coordination in knowledge development, innovation, and sharing of best practices.

Each week, PHAC receives measles surveillance data from P/Ts and reports cases to the Pan American Health Organization (PAHO). Weekly measles surveillance reports are publicly available on the Canada.ca website.

Measles Vaccination Coverage Rates:
Measles is relatively rare in Canada due to effective vaccination programs. However, it is important that Canadians continue to be vaccinated against measles given the travel-related risks of infection and spread to unimmunized people.

PHAC estimates vaccine coverage through the Childhood National Immunization Coverage Survey (cNICS), conducted every two years. The latest survey completed in 2017 estimated that 90% of Canadian children had received at least one dose of measles vaccine by two years of age. This is below the 95% coverage target for measles vaccines.

None