While there's been a rash of measles stories in the news of late, let's be clear: There is no national outbreak.
At least not yet.
But containing these localized outbreaks quickly is essential. And it may take draconian measures to do so.
Canada officially eliminated measles in 1998, meaning it was no longer spread domestically. But measles has come back with a vengeance. Currently, there are two separate events going on simultaneously: There is an outbreak in British Columbia that started in a religious school in Chilliwack and has spread into the community; and there are a series of small, unrelated outbreaks that have occurred in four other provinces – Ontario, Alberta, Saskatchewan, Manitoba – that all began when travellers returned with measles.
There is one overriding reason measles is popping up all over: Too few Canadians, especially children, are being vaccinated. Worldwide, 84 per cent of children have been vaccinated against measles. There is no reason it should not be 100 per cent in Canada.
The majority of the unvaccinated are not anti-vaccination zealots. Rather, they are the blissfully ignorant and the worried well – people who worry more about the imaginary harms caused by "chemicals" in vaccines than the very real harms of infectious diseases. A little history lesson would serve these parents well.
Before the measles vaccine became available in 1963 – when the population was half what it is today – an estimated 400,000 children a year contracted the disease. It killed about 75 children a year and left hundreds brain-damaged. Measles also killed more than three million children a year worldwide; today that number is down to just over 120,000. (While measles is known for the itchy spots it causes, the real danger is fever, which can lead to pneumonia, encephalitis and meningitis.)
In Canada, we don't see the harms caused by measles any more and, as a result, take the benefits of vaccination for granted. The current outbreaks should set off alarm bells on two fronts.
No one should travel abroad without ensuring their vaccinations are up-to-date. All the current cases began with measles infections imported by Canadians who travelled to the Netherlands, the Philippines and Thailand. In some cases, they also returned to families or religious communities that shun vaccination, allowing the disease to get a foothold.
Canada could bar visitors who have not been vaccinated against the measles – but that would be difficult to enforce and, besides, it is Canadian citizens who are the problem. The solution has to come domestically. The first and most important step is education. But some more draconian measures are required to protect the broader population from the folly of a minority.
Most schools in Canada require proof of childhood vaccinations before admission, but there are too many exemptions. Consider that the measles vaccination rate at one "alternative" school in Toronto is a mere 43 per cent, according to a recent story by Global News. There is no excuse for that sort of contempt for public health. Health-care professionals have to do their part as well. When parents refuse vaccination, a doctor cannot just shrug it off; there needs to be push-back.
We also have to ensure that health workers are vaccinated, especially those who work in hospitals, where immunocompromised children are in great danger from measles.
We are rapidly approaching the point where, statistically, a child is going to die of the measles in Canada. That is unconscionable in the 21st century. We shouldn't wait until that happens to be outraged. The time to crack down is now before any more entirely preventable harm occurs.
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