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One year since measles began ravaging Canada, the outbreak has subsided, but the virus shows no signs of being eliminated.
This week, the World Health Organization and Pan American Health OrganizationHe said measles has made a “global comeback,” with Canada currently reporting the highest total number of cases in the Americas region.
The Public Health Agency of Canada said it considers Oct. 27, 2024, the start of an outbreak that has affected more than 5,000 confirmed and probable cases of the highly contagious airborne measles virus. Two deaths in this outbreak, one in ontario and one in albertaIt occurred among babies who were born prematurely and contracted measles in the womb.
While Canada managed Measles eradication status in 1998.Doctors are in suspense over the possibility that it will lose that status and join the ranks of places where it is constantly present, currently at low levels.
“It’s important to think about who else is on that list,” said Dawn Bowdish, a professor in the department of medicine at McMaster University and an immunologist. “Places in the world that are experiencing wars, major civil unrest, or have no public health infrastructure.
“To have a country like Canada on that list is downright shocking.”
Without a doubt, keeping any disease at bay forever is difficult, as international travel will continue to reintroduce the measles virus to Canada.
But doctors say there are other problems here at home, from distrust of medical officials in vulnerable communities to broader misinformation about vaccines. could set the stage for future shoots. This is what they would like to see changed.
Address vaccine misinformation
The pan-Canadian outbreak began when an international traveler attended a wedding in New Brunswick last October, unleashing embers of cases that reached Ontario, Manitoba, Quebec, Alberta, Saskatchewan, Prince Edward Island, the Northwest Territories, Nova Scotia and British Columbia, primarily among unvaccinated communities, Canadian officials say. health.
In Canada and around the world, vaccine misinformation threatens immunization efforts.
The measles-mumps-rubella vaccine has been studied “backwards, backwards and sideways in terms of safety,” said Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta.
Measles can start out as a bad cold, with symptoms such as high fever and cough, but in rare cases it becomes fatal. For one girl, complications arose about a decade later, depriving her of speech, movement and, ultimately, her life.
But persistent and heavily organized misinformation campaigns about the measles vaccine have left some people feeling scared, which Saxinger called embarrassing. He said countering such campaigns will require a concerted effort, such as hiring people to make debunking videos, rather than health professionals volunteering to do it informally.
“It is also necessary to take a somewhat critical look at the algorithms and how social networks are shaping misinformation and whether there is any amplification of misinformation that should be analyzed through [a] legislative lens, which has been made in europe“.
Public health messages are undermined by misinformation, said Dr. Issac Bogoch, an infectious disease specialist at Toronto University Health Network. “We can see online misinformation amplified and it has real-world consequences.”
The question of trust
In Canada, measles outbreaks in both Ontario and Alberta have focused on unique, close-knit, religiously and culturally distinct communities, Saxinger said.
“You need to build a lot of trust in some groups of the population,” Saxinger said. “Honestly, that’s something there has to be continued investment in.”
While measles is a disease that can be well controlled and potentially even eliminated with existing tools, Saxinger estimated that half a million people are not immune to measles in Alberta alone, based on vaccination rates and blood tests for antibodies.
scattered Mennonite communities in southwestern ontario were deeply affected by the province’s measles outbreak.
Catalina Friesen, a personal support worker at the Central Community Health Center in Alymer, Ont., near London, speaks low German and works with a nurse practitioner in a mobile clinic to translate during medical visits.
“They won’t come see us if they don’t trust us,” Friesen said. By being part of the community, Friesen said she can understand what families are going through and help them see the importance of vaccination and preventing the spread of measles by staying home when they are sick.
“I don’t think they’re specifically worried about the measles vaccine. I think they’re just worried about being told what to do when they don’t want to do it.”
Friesen said the mistrust among Mennonites stems from mistreatment over the past 100 years, including offers of autonomy by officials who were not followed through.
They call for vaccine registration
Knowing whether someone is vaccinated against measles would be helpful to doctors and nurses in Ontario hospitals who see symptoms like fever and rash all the time, said Dr. Jeffrey Pernica, a pediatric infectious diseases doctor at McMaster Children’s Hospital in Hamilton, Ont.
“It’s not that urgent care doctors or the [emergency department] or some other family doctor will know if a given person is vaccinated, greatly impeding their ability to provide care.”
Immunization records in Ontario are currently scattered among individual doctors’ offices that are not always shared with local public health units, or may be written down on sheets of paper that can get lost.
When a measles exposure occurs, connected, easily accessible records would also help health care providers in hospitals who currently have to spend time searching for information about who has been vaccinated, Pernica said.
“It makes a lot of sense to have provincial vaccine registries that are compatible with each other, so that we have a national view of where some of these hotspots might be,” said Bogoch, who called it a “no-brainer” to have a national vaccine registry for routine childhood immunizations. Ontario’s chief public health officer has He also called for a national registry to guide public health responses.
Bowdish, the immunologist, said Canadians who move between provinces and territories would also benefit from less reliance solely on paper vaccination records.
“Canadians are a very mobile group and many people, including myself, have received vaccines in different provinces,” Bowdish said. “It’s very difficult to track them down in provincial records. Much easier at the national level, right?”
Looking ahead, the massive global resurgence of measles makes it “inevitable” that measles will reach Canada again, Bogoch said. To prevent long chains of transmission from being triggered, vaccination rates need to be increased.
“It’s easy to say, but of course it takes time, effort, energy and resources to achieve it.”
