Measles Resurges Across Canada as Global Outbreak Intensifies

A year after measles began spreading in Canada, the outbreak has subsided but the virus continues to pose a significant threat to public health. Canada currently reports the highest number of measles cases in the Americas, according to recent statements from the World Health Organization and Pan American Health Organization, which have declared a “global comeback” of the disease.

Since October 27, 2023, the Public Health Agency of Canada has confirmed more than 5,000 cases of the highly contagious airborne virus. The outbreak has claimed two lives – infants in Ontario and Alberta who contracted measles in utero after being born prematurely.

The situation has raised alarms among medical professionals who fear Canada may lose its measles eradication status, achieved in 1998. Such a development would place Canada alongside countries experiencing wars, civil unrest, or those lacking robust public health infrastructure.

“To have a country like Canada on that list is frankly shocking,” said Dawn Bowdish, professor in McMaster University’s medicine department and an immunologist.

The pan-Canadian outbreak originated when an international traveler attended a wedding in New Brunswick last October. From there, cases spread to Ontario, Manitoba, Quebec, Alberta, Saskatchewan, Prince Edward Island, the Northwest Territories, Nova Scotia, and British Columbia, primarily affecting unvaccinated communities.

Disinformation and Trust Challenges

Health experts point to vaccine misinformation as a major obstacle to containment efforts. Dr. Lynora Saxinger, an infectious diseases specialist at the University of Alberta, emphasized that the measles, mumps and rubella vaccine has been thoroughly studied for safety, yet persistent disinformation campaigns have created fear among certain populations.

“There also needs to be a bit of a critical look at algorithms and how social media is shaping disinformation and whether there’s some amplification of disinformation that needs to be looked at through a legislative lens, which has been done in Europe,” Saxinger said.

Dr. Isaac Bogoch from Toronto’s University Health Network reinforced this concern, noting: “We can see disinformation online amplified and it has real world consequences.”

The outbreaks in Ontario and Alberta have been concentrated in close-knit religious and culturally distinct communities. Mennonite communities in southwestern Ontario were particularly affected. Experts stress that building trust with these communities requires sustained investment and culturally sensitive approaches.

Catalina Friesen, a personal support worker with the Central Community Health Centre in Aylmer, Ontario, works as a translator at a mobile clinic serving Mennonite families. Speaking Low German, she helps bridge the cultural divide.

“They won’t come see us if they don’t trust us,” Friesen explained. “I don’t think they’re worried about specifically the measles vaccine. I think they’re just worried about being told what to do when they don’t want to do it.”

This mistrust, according to Friesen, stems from a history of mistreatment over the past century, including unfulfilled promises of autonomy.

Calls for Improved Vaccination Systems

Healthcare professionals are advocating for a national vaccine registry to streamline response efforts. Dr. Jeffrey Pernica, a pediatric infectious disease physician at McMaster Children’s Hospital in Hamilton, Ontario, highlighted how fragmented vaccination records hamper effective care.

“It’s not as though doctors at urgent care or the emergency department or some other family doctor will know if a given person is vaccinated, which greatly impedes their ability to deliver care,” Pernica said.

In Ontario, vaccination records are scattered across individual medical offices, often on paper documents that can be misplaced and aren’t consistently shared with local public health units. During measles exposures, healthcare providers waste valuable time tracking down vaccination information.

Bogoch called a national vaccine registry for routine childhood immunizations a “no-brainer” to help identify vulnerable populations. Ontario’s chief public health officer has also supported such a registry to guide public health responses.

Bowdish pointed out that Canadians’ mobility between provinces makes tracking immunization records particularly challenging. “Canadians are a very mobile bunch and many people, myself included, have had vaccines in different provinces. Very hard to track those in provincial registries. Much easier at a national level,” she said.

Experts warn that the massive global measles resurgence makes future outbreaks in Canada inevitable. Based on vaccination rates and antibody testing, Saxinger estimates half a million people in Alberta alone lack immunity to measles. Preventing future transmission chains will require significantly higher vaccination rates across the country.

“Easy to say,” Bogoch concluded, “but of course it takes time, effort, energy, resources to get that done.”