Measles has had a busy start to 2019. In Vancouver this week, “several” measles cases were reported at local schools. The state of Washington declared a public health emergency in late January, responding to an outbreak that has infected 54 people so far. Measles killed 72 people in Europe in 2018, the World Health Organization announced in February, and Madagascar is also seeing an outbreak. The World Health Organization (WHO) even declared the anti-vaccination movement one of 2019’s top 10 health threats, saying that measles cases have risen globally by 30 per cent, though not all of these cases are attributable to vaccine hesitancy. Measles is much, much less common in Canada than it was before the first vaccination was approved in 1963, but public health physicians are worried about the disease coming back. Story continues below advertisement Here’s why. Measles can be deadly Measles was once a very common childhood disease, and most people who got it recovered completely. Some didn’t though. Measles-related deaths were very common in the early 1900s, according to the Public Health Agency of Canada. The government only started keeping track of the number of cases in 1924, but in 1926, 892 deaths were reported from measles. Between 1969 and 1979, after the vaccine was approved, there was a total of 129 measles-related deaths. By the early 1980s, there were only one to three deaths per year. Recently, says PHAC, they’re unaware of any measles deaths in Canada. But measles still kills people — around 110,000 people died from measles-related complications worldwide in 2017, according to the WHO. Story continues below advertisement It’s hard to estimate the exact mortality rate for measles in a developed country like Canada says Public Health Ontario, partly because we see so few cases, but the agency’s Dr. Natasha Crowcroft estimates that one out of every 3,000 to 5,000 children who get it will die. “There’s nothing else where you would accept a risk of one in 3,000-5,000 of your child dying,” said Crowcroft, who is PHO’s chief of applied immunization research and evaluation. “If you were going to Canada’s Wonderland, and they said, ‘It’s a really safe ride but every 3,000-5,000 rides, someone is going to die,’ nobody would get on that ride.” Tweet This Click to share quote on Twitter: "If you were going to Canada's Wonderland, and they said, 'It's a really safe ride but every 3,000-5,000 rides, someone is going to die,' nobody would get on that ride." The U.S. Centers for Disease Control has an even higher estimate: that for every 1,000 children who catch measles, one or two will die from it. Serious complications include encephalitis — a swelling of the brain that can result in death or brain damage — and pneumonia. A more common complication, ear infections, can lead to permanent hearing loss. “This is a serious disease. It causes serious complications which ultimately can result in death,” said Dr. Gerald Evans, chair of the division of infectious diseases at the Queen’s University faculty of medicine. Story continues below advertisement And once you have measles, there’s not a lot you can do about it. “Other than the vaccine we don’t have a treatment for measles. So we don’t have antiviral drugs like we do for influenza and stuff like that. With measles, it’s really just supportive care.” Measles is incredibly contagious Unfortunately, measles is also “unbelievably easy” to catch, Evans said. How easy? Look at something disease experts call the “basic reproduction number,” a measure of how infectious something is. Influenza has a basic reproduction number of about 2, which means that every person who has the flu will likely give it to two other people. Measles has a basic reproduction number of around 18. Story continues below advertisement “If I have measles and I walk into a room full of people who have not been vaccinated and never had measles themselves,” Crowcroft said, “on average I would infect another 18 people and each of those people would infect another 18 people.” Related News Health officials confirm ‘several’ cases of measles at Vancouver schools As one of the world’s most contagious diseases, measles spreads through the air, making it much easier to catch than say, HIV, which is only transmitted through certain bodily fluids. The virus can even remain hanging in the air long after the infected person is gone, she said. So if someone with measles coughs in a room and leaves, and you go in two hours later, you might still catch their disease. Measles is largely preventable Fortunately, we have a measles vaccine and have for decades. And it works pretty well, conferring more than 95 per cent protection under the current two-shot regime, said Evans. And despite what some high-profile figures have been tweeting this week, there’s no advantage to getting measles as a child, Evans said. Catching measles is not a “natural” part of childhood, said Crowcroft. Story continues below advertisement “It gives you immunity naturally. It also naturally gives you brain damage. It also naturally kills you. Tweet This Click to share quote on Twitter: "It gives you immunity naturally. It also naturally gives you brain damage. It also naturally kills you. “It used to be quite natural for children to die all the time from all sorts of infectious diseases,” she said. “You could say it’s a part of childhood if you accept that it’s OK for children to die from infectious diseases in a situation where you could prevent them.” The vaccine has been used for decades, so public health officials have good safety data on it, she added. Side effects are rare and treatable. “Of all the things you have to worry about: getting lunch ready for tomorrow, getting your kids to school on time, global warming (…) vaccines are not one of the things you need to worry about,” she said. It’s also important to get vaccinated to protect those who can’t: infants under one-year-old and people with compromised immune systems, she said.<doc-sep>A new case of measles has been confirmed in British Columbia – the province’s second case of the virus this year. Vancouver Coastal Health told CTV Vancouver that a person in its territory was diagnosed with measles on Thursday. The patient has already passed through the infectious stage of the virus. Another case of measles was diagnosed in B.C. in early January, according to the Public Health Agency of Canada. That was the only confirmed case of measles in Canada in 2019 as of Jan. 26, the latest date for which PHAC data is available. Travellers at Pearson International Airport in Mississauga, Ont., were warned last week that people who were in the airport’s Terminal One for a four-hour period on Jan. 27, may have contracted the disease. Passengers aboard a Lufthansa flight from Germany and an Air Canada flight to Montreal were also potentially at risk. Public health officials in Vancouver have said the latest case of measles there is not connected to the outbreak in Washington state, where 53 cases of the virus have been reported in Clark County since the start of the year, with one more in King County and four others in neighbouring Oregon. Nearly all of the measles cases have been diagnosed in patients who were never vaccinated against the virus. Separately, the federal government has issued travel health notices regarding measles outbreaks in Europe, Africa and South America.<doc-sep>The man whose family is at the centre of a measles outbreak in Vancouver said he didn't vaccinate his children because he distrusted the science at the time. In an exclusive interview with CBC News, Emmanuel Bilodeau said he and his then-wife were influenced by reports that linked the vaccine that prevents measles, mumps and rubella (MMR) with autism. "We worried 10-12 years ago because there was a lot of debate around the MMR vaccine," said Bilodeau. "Doctors were coming out with research connecting the MMR vaccine with autism. So we were a little concerned. "​​ The MMR vaccine prevents measles, mumps and rubella by helping the body make antibodies to fight off the viruses. The BC Centre for Disease Control (CDC) recommends children receive two doses of the vaccine, one at 12 months of age and the second dose at four to six years of age. There is no scientific evidence linking the vaccine to autism, says the CDC. Bilodeau said he knows now the link between the MMR vaccine and autism has been debunked. "We're not anti-vaccination," he said. "We're just very cautious parents and we just tried to do it in the manner that was the least invasive possible on the child's health." "We were hoping we could find a vaccine that was given in a separate shot so it wasn't such a hit on the kid," he said. Family trip abroad Bilodeau believes one of his three sons contracted measles during a family trip to Vietnam earlier this year and that it has since spread at the French-language schools his children attend. Dr. Althea Hayden of Vancouver Coastal Health (VCH) said on Friday Vancouver was facing an "outbreak" of measles after confirming eight cases affecting students, staff and parents at École Jules-Verne and École Anne-Hébert in South Vancouver and École Rose-des-vents in Oakridge.​ Bilodeau said he brought his sons to a travel clinic on Broadway Street before their trip where they received other vaccinations, but not for measles. It was on the plane ride home that his 11-year-old son began experiencing symptoms, including fever. Bilodeau's son is shown with a rash on his back caused by measles. (Submitted by Emmanuel Bilodeau) Bilodeau brought him to B.C. Children's Hospital on Jan. 21. He said medical staff were aware that the boy hadn't been vaccinated, but they ruled out measles and instead conducted tests for malaria and influenza. His other two sons started showing symptoms soon after, but it took several trips to the hospital before it was determined measles was the culprit although Bilodeau says he mentioned the possibility to doctors. A spokesperson for B.C. Children's Hospital declined to comment on this specific case but provided a statement by email. "Our physicians and staff thoroughly assess each child that presents in our Emergency Department and treat them accordingly. Should a parent raise a concern about a specific disease, including measles, it would be discussed and then followed up on as appropriate," said the statement. A blood test ordered by VCH has since confirmed his youngest son has measles, and the other two are still waiting for confirmation, Bilodeau said. 'Vaccine hesitancy' concerning Monika Naus, medical director at CDC, said "vaccine hesitancy" among parents could lead to a resurgence of preventable diseases. "We've been concerned about that in British Columbia for a long time," said Naus.​​ Measles can lead to serious complications in some children, including pneumonia, encephalitis or death.<doc-sep>Share this Story: Measles case confirmed in Vancouver; not linked to Washington outbreak Measles case confirmed in Vancouver; not linked to Washington outbreak The Vancouver resident was diagnosed on Thursday as having the virus, but the period during which it is considered infectious has passed. Photo by Jeff J Mitchell/Getty Images Article content Health authorities have confirmed a case of measles in Vancouver. The patient, a Vancouver resident, was diagnosed on Thursday as having the virus, but the period during which it is considered infectious has since passed, said Shaf Hussain, a spokesman for Vancouver Coastal Health. The patient is receiving care. We apologize, but this video has failed to load. tap here to see other videos from our team. Try refreshing your browser, or Measles case confirmed in Vancouver; not linked to Washington outbreak Back to video The health authority last released a measles alert in September, when a person who was infected attended the Skookum Festival. The latest case is not believed to be linked to an outbreak of measles in the state of Washington, Hussain said. A surge in measles cases prompted Gov. Jay Inslee to declare a state of emergency Jan. 25. As of Saturday, 54 cases had been confirmed. Health officials are urging residents to get immunized. Four more cases have been confirmed in Oregon. Measles is highly infectious and spreads through air when an infected person coughs or sneezes, according to the Vancouver Coastal Health. Complications can include inflammation of the brain, convulsions, deafness, brain damage and death. Advertisement Story continues below This advertisement has not loaded yet, but your article continues below. Article content Infection does not require close contact and measles can survive in close areas, such as a bathroom, for up to two hours after an infected person has left. It causes fever, red eyes, cough, runny nose and a rash. Most people recover within a week or two. Vancouver Coastal Health recommends vaccinations. People who have previously had the infection do not need immunization. B.C. children born in or after 1994 routinely get two doses of the measles, mumps and rubella (MMR) vaccine, one dose when they turn a year old and another before they start kindergarten. People born before 1994 or who grew up outside of B.C. may need a second dose. People born before 1970 are likely immune; but if they aren’t sure whether they have had the infection, they can safely get the MMR vaccine. The B.C. Centre for Disease Control tracks child immunization and reports that 82.1 per cent of children aged seven had been immunized for measles in 2018, compared to 88.4 per cent in 2017 and 90.2 per cent in 2016. Across Canada, only a single new case of laboratory-confirmed measles was reported between Dec. 30, 2018, and Jan. 26, 2019, according to Health Canada’s most recent measles and rubella monitoring reports. The agency said there have been large measles outbreaks reported across Europe which have affected many countries. neagland@postmedia.com twitter.com/nickeagland Share this article in your social network Latest National Stories Advertisement Story continues below This advertisement has not loaded yet, but your article continues below. Vancouver Sun Headline News Sign up to receive daily headline news from the Vancouver Sun, a division of Postmedia Network Inc. Email Address There was an error, please provide a valid email address. By clicking on the sign up button you consent to receive the above newsletter from Postmedia Network Inc. You may unsubscribe any time by clicking on the unsubscribe link at the bottom of our emails. Postmedia Network Inc. | 365 Bloor Street East, Toronto, Ontario, M4W 3L4 | 416-383-2300 Thanks for signing up! A welcome email is on its way. If you don't see it please check your junk folder. The next issue of Vancouver Sun Headline News will soon be in your inbox. We encountered an issue signing you up. Please try again Trending<doc-sep>
Canada could experience the same type of measles outbreaks that Washington and New York states are currently facing because of low vaccination rates and the highly contagious nature of the virus, public health experts warn. Measles is one of the most highly contagious viruses in existence, which makes the prospect of an outbreak frightening. It’s so contagious that it can live in an air space for two hours. This means that if an infected person coughs or sneezes in a room, and then leaves, an unvaccinated person who enters the room two hours later can still get measles. According to the U.S. Centers for Disease Control and Prevention, if a person has measles, 90 per cent of those in proximity will also contract the virus unless they have been vaccinated or are immune. Measles spreads through direct contact or through the air. It causes a range of symptoms including fever, cough and a rash. But it can also lead to serious, life-threatening complications, including blindness, inflammation of the brain and pneumonia. Children are most susceptible to the risks. According to the World Health Organization, before the introduction of measles vaccination in 1963, the virus caused 2.6 million deaths every year. Story continues below advertisement That helps explain why public health officials get so concerned when outbreaks occur, which they have been with increasing frequency in recent years. In Madagascar, officials say more than 50,000 people have been infected with measles in recent months and more than 300 people, mostly children, have died as a result. The Philippines is also battling a major outbreak, with more than 1,800 cases and 26 deaths. So far in the U.S. this year, about 80 cases of measles have been reported, with two outbreaks ongoing in Washington and New York states. In Washington state, permissive vaccination rules are being blamed for the outbreak. In Clark County, which has so far seen 49 measles cases in children mainly under 10, only 78 per cent of young people from kindergarten through high school have been vaccinated. Similar outbreaks have been occurring in Europe: In 2017, there were 25,863 cases of measles; last year, that surged to more than 82,000. While families in Madagascar have difficulty accessing the measles vaccine, outbreaks in Europe and the U.S. are often linked to vaccine hesitancy – the reluctance of parents to vaccinate their children because of unfounded fears about the treatment. Concern over the vaccine can be traced back to a 1998 paper by former doctor Andrew Wakefield, who falsely linked the measles, mumps and rubella vaccine to autism. The paper was completely debunked and retracted and Mr. Wakefield lost his medical licence, but the damage was done. Canada has been free of endemic measles since 1998, meaning the virus isn’t constantly present. It’s now reintroduced after someone who travels outside the country gets infected. If people aren’t vaccinated, the virus can spread easily. Canada has had a number of measles outbreaks in recent years. Joan Robinson, a pediatric infectious diseases physician and editor of the Paediatrics & Child Health Journal, said that outbreaks often occur in small communities where children aren’t vaccinated. Part of the challenge facing public health officials is that Canada doesn’t have a national vaccination registry and provinces track vaccine rates differently, meaning it can be difficult to get an accurate, real-time sense of how many people are up-to-date on their shots – and where pockets of low immunization are. Story continues below advertisement “I think ‘patchwork’ is a good word to use to describe it,” said Vinita Dubey, associate medical officer of health with Toronto Public Health. Only two provinces, Ontario and New Brunswick, require children to have updated vaccination records in order to enter school. There have been calls in recent years for Canada to start a national registry to help officials keep better track of vaccination rates. Dr. Robinson wrote a statement last year for the Canadian Paediatric Society on problems with vaccination rates in Canada. She notes that in many parts of the country, rates are only estimates, but even still, they point to signs of trouble. In Manitoba, for instance, only 66 per cent of two-year-olds are up-to-date for all vaccines, including measles, mumps and rubella. In Quebec, it’s 85 per cent and in B.C., it’s 73 per cent. Experts say vaccination rates need to be 90 to 95 per cent in order to achieve herd immunity, which stops the spread of infectious disease.