For doctors who worked for years in the ‘90s to help Canada achieve measles elimination status, Monday was difficult. “The dominant emotion I have is sadness, and then a little bit of anger,” said Dr. James Talbot, former chief medical officer of health in Alberta. “So many people worked so hard over many years to get that status, and to see it squandered … is hard to take.” The Pan American Health Organization announced Monday it would strip Canada of its elimination status after a year in which the country has recorded more than 5,000 cases. Measles is a highly contagious virus, but also highly preventable, with two doses of the measles, mumps and rubella (MMR) vaccine. “Losing elimination is the canary in the coal mine,” said Talbot, who warns the inability to get outbreaks under control is evidence of larger problems. “This is a disease we know what we need to do to bring it back under control,” he said. “We just need the political leadership and resources to make that happen, and — I am not sure, at least in a couple of provinces — that that leadership exists.” Public health officials say Canada’s measles outbreak began Oct. 27, 2024, when an international traveller attended a wedding in New Brunswick. Guests at that wedding then returned to Southwestern Ontario, where an outbreak began among the close knit Mennonite community. From there, cases have been reported in every province, except for Newfoundland and Labrador, as well as the Northwest Territories. Ontario and Alberta, together, account for 84 per cent of all cases. The vast majority of infections have been among the unvaccinated. “I think this was predictable,” said Monika Naus, a public health professor at the University of British Columbia. While Naus says public health officials have been working in the last year to reign in the spread of the virus, they are faced with numerous obstacles. Among them is worker burnout from the COVID-19 pandemic and declining resources. “What people in leadership positions need to consider is the cost of not controlling the measles,” she said. In order for Canada to regain its measles elimination status, it will need to end the current spread of the virus and show that transmission has stopped for at least a year. Among the recommendations given to Canadian public health officials from the World Health Organization (WHO) is to focus on increasing vaccination rates, establish a national vaccination registry and increase the resources for public health officials to respond to outbreaks when they happen. But during a time of political polarization and increasing vaccine hesitancy, experts say it could be a long road. “I think we have a tolerant approach to people who choose not to get vaccinated,” said Naus. “As long as that remains, we will have vulnerable populations and that’s something we will have to live with. The question is: can you maintain elimination status when you have type of population in your midst?”
