Ontario could be seeing 'sporadic' community transmission of measles

Health experts say there is the potential for small-scale “sporadic” community transmission of measles in Ontario after a vaccinated adult contracted the disease.

Speaking with CTV News Toronto, York Region’s Medial Officer of Health Dr. Barry Pakes said this kind of case is rare.

“Measles is extremely transmissible. It's much more transmissible than even the most transmissible version of COVID-19,” Pakes said, adding the disease can continue to live in a room two hours after someone with measles leaves it.

“We know a very small degree of measles that has circulated somewhere in the community in the (Greater Toronto Area), potentially in York Region here, which is where this person got it. That means potentially there may be other folks who may have been exposed.”

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Public health officials confirmed last week that they were investigating what they called a “unique” case of measles in a patient who was in their 30s.

Pakes said the patient’s symptoms were not severe, likely due to their vaccinations.

“We are not seeing widespread community transmission,” Pakes stressed.

“And we don't expect that because we really do have excellent measles vaccine coverage throughout the entire population.”

Five cases confirmed in Ontario so far

Four other cases in children have been confirmed in Ontario. All of them had recently travelled abroad.

Here’s what we know about them:

• Peel Public Health confirmed on Feb. 13 that a child was diagnosed with measles
• An infant was hospitalized in Toronto after contracting measles on Feb. 16
• On Feb. 28 officials in Brant County confirmed a child under the age of 10 had been hospitalized with measles.
• Windsor-Essex County Health Unit confirmed on Jan. 30  its first case of measles in 20 years

Public Health Ontario says all lab-confirmed cases are "thoroughly investigated to identify the likely source of infection and to identify rare instances where the source of infection for the case is unknown."

"These detailed investigations will continue for any future cases that are confirmed in 2023," a spokesperson said.

As of Feb. 23, there were six active cases of measles in the country. According to the Public Health Agency of Canada, most were in unvaccinated or under-vaccinated children who had travelled internationally.

However, the number is slowly growing. On Monday, another confirmed case was reported in British Columbia.

‘Certainly looks like’ measles community transmission

Infectious Diseases Specialist Dr. Isaac Bogoch said it “certainly looks like” there may be community transmission of the measles, citing two cases in Ontario and Quebec in which there is no travel history and no obvious contact with infected individuals.

“That just means that they acquired that infection locally,” he told CTV News Toronto.

“That means there's someone walking around Southern Ontario or someone walking around Quebec with measles who is transmissible, who is infecting others.”

He noted that given the global rise in measles infections, Canada will likely see a slight rise in cases, which is why vaccination is so important.

“There's 15 million Ontarians and certainly there are some communities that are doing terrific, but it's also fair to acknowledge that there are pockets and areas where vaccine rates are slipping—either people are choosing not to get vaccinated or they might be under vaccinated,” Bogoch said.

“We know there were significant disruptions during the darkest days of the pandemic and some people might have inadvertently missed some routine immunization,” Bogoch said.

“I think we have to acknowledge that there is an uphill battle against misinformation, and disinformation campaigns that are often amplified online. And I think that poses a significant challenge.”

CTV News Toronto reached out for an updated statement from Ontario’s Medical Officer of Health and was directed to a Feb. 20 memo that warned public health units to prepare for more cases and “potential outbreaks” amid a rise of infection in Europe.

The memo acknowledges that with March Break coming up, healthcare practitioners should encourage vaccinations and report possible 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,” Moore wrote.

“Importation and resultant local transmission can, and has, led to measles outbreaks in Canada.”

What is measles?

Measles are highly contagious, with symptoms that include red rashes, fever, cough, runny nose, red eyes and fatigue. Individuals can also get unusla white spots in their mouth.

Pakes adds that “in some ways it can mimic the symptoms of a regular cold.” However, those that have one or two symptoms likely don’t need to worry, as “it’s all the symptoms together.”

“We're making sure that people know how to test for it so that we can catch every single possible case and make sure that it doesn't start transmitting in North America or certainly in the GTA,” he said.

“It's been eradicated or eliminated, rather, in North America and Canada since 1998, and all of the Americas for a few decades now. And we really don't want to have that it reintroduction.”

The viral infection spreads through the air and close contact. Symptoms can start to present themselves anywhere from seven to 21 days after exposure.