Measles: What to know as number of cases in Ontario surpass 2023 total, 14 cases found in Montreal

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Measles cases are appearing in some parts of Canada, including in Ontario, where the number of infections in the past few months have already surpassed last year's total.

The latest case in the province was confirmed in a child who was infected during a recent trip to India, according to Hamilton Public Health Services. While the child is recovering at home, the health agency noted it's following up with people within the city who might've been exposed to measles from this case.

That includes people who were on the Saudi Arabian Airlines Flight SV 61 from Jeddah on March 5, which left the city at 9:40 a.m. and landed at Toronto Pearson International Airport at 3:25 p.m. Furthermore, people inside the Toronto airport's Terminal 3 between 3:25 p.m. and 8:30 p.m. might've been exposed.

With this new case, Public Health Ontario reported there have been eight lab-confirmed measles cases so far in 2024. Of those infections, six were travel related and two had an unknown exposure source. In 2023, there were a total of seven lab-confirmed cases.

This comes as Montreal Public Health confirmed the city has seen 14 lab-confirmed measles cases since the beginning of February, with a total of 19 cases reported in the province as of Tuesday afternoon.

Last month, Ontario chief medical officer of health Dr. Kieran Moore urged health system partners in Ontario to "be prepared for the continued importation of cases and potential outbreaks," amid a global rise of measles cases.

"While measles is no longer considered endemic in Canada, outbreaks can happen when susceptible individuals (e.g., unvaccinated) travel to and return from countries where measles is circulating," he noted in a memo, while also pushing health-care providers to encourage vaccinations for measles.

In mid-February, Peel Public Health had been investigating its own case of measles in the region from a child who had recently travelled abroad. "A reminder for anyone who is planning international travel to a destination with high levels of measles to ensure they are immunized against measles," the health agency noted, reminding Ontarians are eligible for two publicly-funded doses of the MMR vaccine.

A November report from the World Health Organization (WHO) and the Centers for Disease Control confirmed measles cases are rising worldwide — and more people are dying from it. The report indicated there was an 18 per cent increase in estimated measles cases and a 43 per cent increase in estimated measles deaths in 2022 compared with 2021.

Researchers said this is a result of millions of children missing measles vaccinations during the COVID-19 pandemic. "Global coverage with measles-containing vaccine (MCV) declined during the COVID-19 pandemic to the lowest levels since 2008, and measles surveillance was suboptimal," the report said.

Canadian infectious disease specialist Dr. Isaac Bogoch previously told Yahoo Canada he wasn't surprised by the report, adding it was clear there was "a breakdown of many public health programs throughout the course of the pandemic."

Bogoch described the virus as the "canary in the coal mine" of public health, adding outbreaks are "visible, and they're explosive, and obviously, they can be devastating."

In 2022, there were 136,200 deaths from measles. Nearly all of those deaths were children, the majority of whom were under the age of five.

Should Canadians be worried about these rising numbers or the recent cases found closer to home? Read on to learn everything you should know about measles and prevention.

What is measles?

According to the WHO, measles is a "highly contagious disease" caused by a virus of the same name.

It "spreads easily when an infected person breathes, coughs or sneezes," the agency explained, adding the virus attacks the respiratory system first, before spreading through the body.

Symptoms can include:

• a high fever

• coughing

• a runny nose

• a rash all over the body

• red and watery eyes

• small white spots inside the cheeks

Complications from measles are what causes the majority of deaths, including:

• blindness

• encephalitis (an infection causing brain swelling or damage)

• severe diarrhea and dehydration

• ear infections

• severe breathing problems

These complications are most likely to occur in children under five years old and adults over 30, the WHO said.

Bogoch added there's a misconception, "some people think measles is no big deal. ... It's important to note that it's associated with significant morbidity. You can get very, very sick from measles."

How common is measles in Canada?

Despite the global surge, Canada has reported very few cases of measles, thanks to the nation's high vaccination coverage. Although, some parts of the country are seeing a decline in vaccine uptake, including Alberta where vaccination rates in 2022 dropped from 2018.

Bogoch noted the few cases seen in Canada are predominantly imported, often originating from regions with lower vaccine rates. However, the issue could be that some Canadian children missed out on routine vaccination during the pandemic.

Current recommendation for routine measles vaccines is two doses, the first administered at 12 to 15 months of age and the second dose at 18 months of age or after, but before school.

"Could we see the propagation of cases in Canada after we'd have an important case, if we do see lapses of vaccination?" Bogoch questioned, answering it wouldn't be surprising. "There's so little wiggle room with with measles."

Should Canadians be worried about rising cases globally?

Bogoch advocated awareness rather than undue concern.

While Canada has few measles cases, individuals who choose not to be vaccinated might face risks, especially when travelling to areas with lower vaccine coverage. It's crucial for Canadians to stay informed about their vaccination status and ensure that routine vaccinations are up to date.

Bogoch said some individuals, despite being pro-vaccine, might not be up to date due to receiving only one dose, especially those born before the 1990s. He encouraged those in doubt to consult health-care providers, including physicians, nurse practitioners or pharmacists.

"One dose provides pretty good protection against measles, but two doses is much better," he claimed.

While Canadians may not face an immediate threat from the global rise in measles cases, awareness and proactive vaccination are essential.

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