Montreal measles outbreak could ‘explode exponentially’: expert

There have been nine confirmed cases in Montreal so far, seven of them due to community transmission.

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Montreal’s measles outbreak risks spreading quickly because of how contagious the disease is and the city’s low vaccination rates, an infectious disease expert warned Thursday.

Quebec is the epicenter of Canada’s latest measles outbreak, with most transmission occurring in Montreal. There have been nine confirmed cases in the city so far, seven of them due to community transmission.

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“My concern is that the numbers will skyrocket exponentially,” said Dr. Earl Rubin, director of pediatric infectious diseases at Montreal Children’s Hospital. “It is not a hypothetical situation. I fear that it is a much more pending reality.”

At a news conference earlier this week, Quebec’s public health director shared similar concerns as he detailed a drop in vaccine acceptance over the years.

Dr. Luc Boileau noted that a 95 per cent vaccination rate is needed for adequate protection, but said in some Montreal-area schools as few as 30 per cent of children are vaccinated against measles.

Across the province, about 98 per cent of high school students and 86 per cent of elementary school students are vaccinated.

However, vaccination rates are significantly lower in the Montreal, Laval and Montérégie regions: Montreal’s overall rate is 82 per cent for secondary schools and 78.5 per cent for primary schools.

As of Thursday, a total of 12 cases had been confirmed in Quebec. In addition to those in Montreal, there were two in Laval and one in the Mauricie region.

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Measles was considered nearly eliminated from North America in the late 1990s and early 2000s, but several factors, including declining vaccination rates, have led to its resurgence.

In an interview Thursday, Rubin said increased immigration, international travel and vaccine hesitancy have contributed to the problem. As does a debunked study linking the vaccine to autism, a theory often endorsed by celebrities.

The near-elimination of the disease also influenced people to choose not to vaccinate their children anymore, Rubin added.

“Because people didn’t have measles and heard about a possible complication from the vaccine (which is incredibly rare), they would tend to say they don’t need the vaccine,” Rubin said. “And that is not valid if people are not vaccinated.”

Beyond the typical red spots, rash and fever, measles can cause serious complications in children and adults.

About one in five unvaccinated people in the United States who get measles end up in the hospital, according to the U.S. Centers for Disease Control and Prevention. Up to three out of every 1,000 children who become infected die from respiratory and neurological complications.

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“It is not a benign disease,” Rubin said, noting that it is also one of the most contagious infectious diseases known.

The virus spreads through the air or by direct contact with an infected person. There is a 90 percent risk of an unvaccinated person contracting the disease if they are near an infected person.

To date, Montreal public health authorities have identified 15 places where the virus could have been transmitted in recent weeks, including emergency departments at the city’s two children’s hospitals.

In a letter sent to parents last week, Montreal public health director Mylène Drouin also noted that there has been at least one case in a school. Drouin urged people who are not protected to get vaccinated as soon as possible.

Two doses of the measles vaccine after one year of age are almost 100 percent effective in preventing the disease. The vaccine is also considered to offer lifelong protection.

In Quebec, people born before 1970 are considered adequately protected even if they are not vaccinated because they were likely exposed to the virus as children. People born after 1980 need both doses of the vaccine to be considered protected.

As for vaccine hesitancy, Rubin encouraged anyone with concerns to discuss them with their doctors.

“It’s a great vaccine,” he said. “Have a frank conversation with your healthcare provider and allow them to address those concerns and any questions people may have.”

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