In 1998, Canada earned its elimination status after a successful, years-long campaign to popularize the measles vaccine. But this past year, the country has seen a dramatic rise in the disease with 5,139 cases.Ahmed Zakot/Reuters
Canadian public-health officials and care providers are watching closely to see if the country loses a significant distinction: its status as a place that has eliminated the spread of measles, considered one of the world’s most contagious diseases.
On Monday, the Pan American Health Organization will provide an update on the current measles situation in the Americas. It will issue findings that follow a review conducted by a body established by the PAHO to evaluate national data. Measles elimination is reached when transmission is interrupted for 12 consecutive months or more.
In 1998, Canada earned its elimination status after a successful, years-long campaign to popularize the measles, mumps and rubella (MMR) vaccine, which public-health officials say is a safe and effective tool to protect against the virus. The U.S. achieved the same victory in 2000.
By stark contrast, health officials have been troubled by the extent of domestic spread this year.
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Cases have been reported in nine provinces and one territory. There had been a total of 5,139 cases across the country as of the end of October, according to a federal measles report.
Deaths have also occurred in the two provinces that had the highest numbers of measles cases: one in Ontario; the other in Alberta. In both instances, infants died after contracting measles in utero and being born prematurely.
Should Canada officially lose its measles-elimination status, public-health researchers say it would not only amount to a bruise on the country’s reputation, but that the return of endemic measles would carry serious health consequences.
For many months, members of Canada’s medical community have warned that the elimination status is in serious jeopardy, including Canada’s outgoing chief public-health officer, Theresa Tam, who called on Canadians in May to bolster vaccinations to stop the disease’s preventable spread.
Dr. Tam, who left her role in June, said if cases were to continue beyond October, the virus would be considered endemic and would continue to circulate domestically.
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A risk assessment conducted by the Public Health Agency of Canada said in July that continued transmission of measles placed the country “at risk of losing its measles-elimination status.” It also said the likelihood of prolonged transmission up to mid-October was high.
Recently, Ontario and Alberta have made significant progress in reducing case numbers.
Ontario’s measles outbreak was declared over on Oct. 6.
Data in the weekly federal measles report from the end of the month shows two cases in Ontario and seven in Alberta. Saskatchewan had the highest number of reported cases: 11.
Isaac Bogoch, an infectious-diseases specialist at Toronto General Hospital who also works in the University of Toronto’s Department of Medicine, said in an interview Sunday that to lose measles-elimination status there must be continuing transmission endemically within the country for a year.
“I don’t think we have that,” he said, noting how the outbreaks in Ontario and Alberta were quelled.
Dr. Bogoch emphasized that Canada should not have seen outbreaks of measles. It is a high-income country relative to the rest of the world, he said, with a very functional public health care system.
But he noted that cases of the virus are inevitable because there has been a large global resurgence of measles that has coincided with an era of unprecedented human mobility.
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“Having said that, when those cases land in our country, we should not be seeing subsequent chains of transmission,” Dr. Bogoch said.
“And unfortunately, we saw that, and we should not be having outbreaks, especially of the magnitude which we saw.”
He also said the outbreaks amount to a warning that vaccination and other public-health programs may be suffering.
Dr. Bogoch said it is a sign to double down on efforts to lower barriers for vaccination, to ensure people have access to primary health care providers and that they can access credible information to make informed decisions.
A study published in the Canadian Journal of Public Health found a decline in measles vaccination coverage in children in 2023 compared with 2019.
Public-health scholars say the decline in vaccination can be attributed to a number of factors including paused school immunization programs during the COVID-19 pandemic, barriers for patients to access primary health care providers, vaccine hesitancy and the rise of misinformation and disinformation.
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Rita McCracken, a family doctor and the lead of primary-care research and development at the Simon Fraser University School of Medicine, said an issue that needs to be discussed more is how barriers for Canadians to access primary care relate to the rise of false medical information and decreased vaccination rates.
A survey commissioned this year for the Canadian Medical Association found that more Canadians are encountering bogus health content, particularly online.
The survey found year-over-year trust in physicians remained stable at 80 per cent. But it also found that one-third of Canadians (35 per cent) reported avoiding effective health treatments because of false information, up six percentage points from 2024.
Doctors say the measles shot is a routine childhood vaccination, with a first dose recommended after a child’s first birthday, at 12 to 15 months of age. A second dose is usually given before children start primary school.
Traditionally, MMR doses are administered through primary health care providers.