Measles out of control ahead of September school start, doctors warn

CBC

a day ago

Several Alberta doctors are warning the province could face "a perfect storm" as measles outbreaks balloon and children head back to school in September.
During a media availability hosted by the Alberta Medical Association on Tuesday, the physicians appealed to parents to ensure their children are vaccinated immediately. And they called on the Alberta government to expand access to an early vaccine dose for babies and to consider requiring proof of immunization in schools.
"There's no doubt that this is an epidemic," said Dr. James Talbot, a former chief medical officer of health for Alberta.
"Worse, there can be no doubt that it's still not under control."
Talbot worries children will be heading back to school in September after having attended family gatherings, sports tournaments, camps and other events where they may have been exposed to measles.
"That represents a perfect storm where our children, grandchildren, nephews and nieces and family members will be at risk, increased risk, of getting measles," said Talbot, who is also an adjunct professor at the University of Alberta's school of public health.
As of midday Tuesday Alberta had reported a total of 1,472 measles cases since the outbreaks began in March — and transmission is showing no signs of slowing down.
The doctors are pleading with Albertans to ensure their children get vaccinated right away.
"The best time to do it is now. Don't wait for the start of the school year. Do it now so they're protected when the school year starts, said Talbot.
"That's the most important back-to-school preparation you can do, even more important than buying a back-pack or lunchbox."
Edmonton-based pediatrician Dr. Tehseen Ladha is worried that the virus, unchecked, could make some children very sick.
"There's this misconception that measles is a routine illness — a routine childhood illness — and it's not," she said.
"It's one of the most contagious viruses on earth. And children, pregnant women and immunocompromised people are amongst the groups most vulnerable to it."
The measles virus can hang in the air for several hours after an individual leaves a location and it can lead to serious complications, including pneumonia, brain swelling and brain damage, premature delivery and even death.
"The risks of getting the illness are much worse and more frequent than getting the vaccine," said Ladha, noting that about 10 per cent of people infected with the virus will end up in hospital.
Extra baby dose
The doctors are renewing calls for the Alberta government to allow babies as young as six months old, living in all health zones, to have access to an early and extra vaccine dose.
The province currently only offers the early shot to babies living in or travelling to the hardest hit south, central and north zones.
"Although there are areas in the province with higher rates of measles, people travel within the province. There are no borders," said Ladha.
"And we are approaching a school start in which there will be many siblings and playmates bringing measles home to their younger sisters and brothers."
Talbot would also like to see the province consider requiring proof of immunization in schools.
Ontario, for example, requires that students be vaccinated against a number of illnesses, including measles.
"Ontario is better situated for September back to school than Alberta is," he said.
If there are outbreaks at schools the physicians warned it may be necessary to send unvaccinated children and staff, who are exposed, home.
"You really are meant to be quarantined for 21 days, I believe," said Dr. Lynora Saxinger, an infectious diseases specialist with the University of Alberta.
"That is a long time and that is for people who are not sick. That is to try and contain the infection and reduce the successive rings of spread. And that's very disruptive."
Measures 'not warranted,' province says
As of July 12, 114 Albertans had been hospitalized due to the illness, including 15 intensive care unit admissions.
No deaths have been reported.
The Alberta government said it is taking the outbreaks seriously and working to limit further spread but that the steps suggested by the physicians are not necessary.
"The response is guided by data and the advice of public health experts, including the Chief Medical Officer of Health," said an emailed statement from the Ministry of Primary and Preventive Health Services.
"We will continue to adjust our approach as needed based on emerging data and expert advice; however, the measures currently being suggested are not supported by the latest data and are not warranted at this time."
The province is pushing back against the idea of offering the early vaccine dose more widely to infants, saying it is an outbreak response in areas where the risk is higher and that the risk in Calgary and Edmonton remains "relatively low."
"Offering early doses more broadly — without an identified need — would not be medically appropriate and could divert resources from areas where they are most needed," the spokesperson said.
Provincial data shows 17 new cases have been reported in the Calgary zone in the last two weeks, bringing the total to 43 cases. The Edmonton zone, which has seen a slower uptick, has reported 16 cases this year.
The government also said it has expanded immunization clinic hours an added clinics in some hard-hit areas.
The spokesperson said the province's tactics, which also include targeted outreach, have worked, and vaccination rates have increased.
"Messaging targeted to parents and guardians of school-aged children ahead of the school year is also being explored," the statement added, noting parents and guardians received a letter from the Chief Medical Officer of Health in June, outlining the risks and importance of immunization.
The province also insists the measles outbreaks don't constitute an "epidemic" or "province-wide outbreak," because the vast majority of cases are outside of Calgary and Edmonton.