Ontario records first measles death since 1989. What parents need to know about the disease & vaccination

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Ontario has reported its first measles death since 1989. The victim, a child under five from Hamilton, was one of five unvaccinated children who contracted measles this year. Now, health officials are warning about the risks of being unvaccinated as measles cases in Canada rise.

As of last week, Ontario has seen 22 measles cases in 2024, accounting for nearly a quarter of the total cases documented over the past decade, the CBC reported. Public Health Ontario revealed an increase in the proportion of seven-year-olds without any measles vaccine doses, up from less than four per cent to nearly 17 per cent between the 2019-2020 and 2022-2023 seasons.

Dr. Allison McGeer, an infectious diseases specialist at Sinai Health System, told the CBC this tragedy was predictable, noting, "There's also a certain aspect of inevitability to it just because of how much ground we lost in measles vaccination around the world" .

Measles is notoriously contagious, with the virus capable of lingering in the air for hours. Unvaccinated children are particularly vulnerable. "If you look at the data from any of the provinces," Dr. McGeer stated, "it's unvaccinated kids who are the problem."

Efforts to curb the spread of measles depend on improving vaccination rates. In Quebec, aggressive public health measures, including contact tracing and post-exposure vaccination, have helped stabilize the situation, despite initially low vaccination rates in some areas.

The recent death in Ontario underscores the need to maintain high vaccination coverage to protect the most vulnerable members of society.

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." Read on to learn everything you should know about measles and prevention.

What is measles and what are its symptoms?

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.

Measles 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?

Measles has seen a resurgence in Canada over recent years. As of 2024, Canada has reported a significant increase in measles cases compared to the previous year. Specifically, there have been 75 cases of measles reported so far in 2024, with 41 of these cases currently active.

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 cases seen in Canada are predominantly imported or linked to travel. Health Canada's risk assessment from March stated there is a "high likelihood of infectious travellers with measles virus continuing to enter Canada and a high likelihood of multiple measles outbreaks." It added major impacts are "expected in health care settings, especially in pediatric facilities, as well as in un/under-vaccinated communities."

Measles vaccine in Canada: What to know

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. It's also recommended to youth who missed the routine immunization, and susceptible adults born in or after 1970.

In Canada, the measles vaccine is only available in combination with mumps and rubella vaccine (MMR) or mumps, rubella and varicella vaccine (MMRV).

According to Health Canada, a single dose of measles-containing vaccine given at 12 or 15 months of age is estimated to be 85 to 95 per cent effective. "With a second dose, efficacy in children approaches 100 per cent."

But, because measles is so contagious, outbreaks have occurred despite high vaccination rates. That's why at least 95 per cent of the population "needs to be immunized to develop herd immunity."

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

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.

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