Measles & Rubella Weekly Monitoring Report – Week 20: May 12 to May 18, 2019

Key Points

In Canada, three new cases of measles and no new cases of rubella were reported in week 20, 2019.
Currently, there are eight active^{Footnote 1} cases of measles in Canada.
Fifty-four (54) cases of measles and no cases of rubella have been reported in Canada in 2019. These cases were reported by Québec, British Columbia, the Northwest Territories, Ontario, Alberta, and New Brunswick.
Globally, there are large measles outbreaks which have affected a large number of countries. Canadians travelling outside of Canada are invited to consult the travel health notices for more information.

Organization: Public Health Agency of Canada

Date published: 2019-05-30

Epidemiological summary

During epidemiological week 20, 2019 three new confirmed cases of measles and no new cases of rubella were reported in Canada^{Footnote 2}. The first and second cases were reported by the province of Quebec: both were exposed to a previously reported case from Quebec. The onset of rash occurred in epidemiological week 19 for the first case and in epidemiological week 20 for the second case. The third case reported by the province of Alberta, with rash onset in epidemiological week 20, was acquired while travelling to Vietnam and Thailand.

To date in 2019, 54 cases of measles and no cases of rubella have been reported. The last case of rubella was reported in 2016 and the last case of congenital rubella syndrome/infection was reported in September 2018.

Figure 1: Number of cases of measles (n=54), rubella (n=0), and congenital rubella syndrome (n=0)^{Footnote 3} by week of rash onset, as reported to the Canadian Measles/Rubella Surveillance System (CMRSS) and Measles and Rubella Surveillance System (MARS), for the period ending May 18, 2019.

Figure 1: Number of cases of measles (n=54), rubella (n=0), and congenital rubella syndrome (n=0) by week of rash onset, as reported to the Canadian Measles/Rubella Surveillance System (CMRSS) and Measles and Rubella Surveillance System (MARS), for the period ending May 18, 2019.
Epidemiological Week of Rash Onset, 2019	Number of confirmed measles cases reported	Number of confirmed rubella cases reported	Number of confirmed congenital rubella syndrome/infection cases reported
1	0	0	0
2	1	0	0
3	0	0	0
4	1	0	0
5	5	0	0
6	2	0	0
7	3	0	0
8	6	0	0
9	4	0	0
10	5	0	0
11	2	0	0
12	2	0	0
13	6	0	0
14	4	0	0
15	3	0	0
16	0	0	0
17	2	0	0
18	2	0	0
19	4	0	0
20	2	0	0
21	0	0	0
22	0	0	0
23	0	0	0
24	0	0	0
25	0	0	0
26	0	0	0
27	0	0	0
28	0	0	0
29	0	0	0
30	0	0	0
31	0	0	0
32	0	0	0
33	0	0	0
34	0	0	0
35	0	0	0
36	0	0	0
37	0	0	0
38	0	0	0
39	0	0	0
40	0	0	0
41	0	0	0
42	0	0	0
43	0	0	0
44	0	0	0
45	0	0	0
46	0	0	0
47	0	0	0
48	0	0	0
49	0	0	0
50	0	0	0
51	0	0	0
52	0	0	0
Missing Rash Onset	0	0	0
Cases (year-to-date)	54	0	0

Geographic distribution

There are currently eight active^{Footnote *} cases of measles reported in Canada.

Figure 2: Distribution of active ^{Figure 2 Table - Footnote *} confirmed measles cases by health region
Health Region	Measles Active Cases
Eastern Regional Integrated Health Authority	0
Central Regional Integrated Health Authority	0
Western Regional Integrated Health Authority	0
Labrador-Grenfell Regional Integrated Health Authority	0
Prince Edward Island	0
South Shore District Health Authority	0
South West Nova District Health Authority	0
Annapolis Valley District Health Authority	0
Colchester East Hants Health Authority	0
Cumberland Health Authority	0
Pictou County Health Authority	0
Guysborough Antigonish Strait Health Authority	0
Cape Breton District Health Authority	0
Capital District Health Authority	0
Zone 1 (NB)	0
Zone 2 (NB)	1
Zone 3 (NB)	0
Zone 4 (NB)	0
Zone 5 (NB)	0
Zone 6 (NB)	0
Zone 7 (NB)	0
Québec et Chaudières-Appalaches	0
Centre-du-Québec	0
Montréal et Laval	3
Ouest-du-Québec	0
Montérégie	0
Nord-Est	0
Ontario Central East	0
Ontario Central West	1
Ontario Eastern	0
Ontario North East	0
Ontario North West	0
Ontario South West	0
City of Toronto Health Unit	2
Winnipeg Regional Health Authority	0
Prairie Mountain Health	0
Interlake-Eastern Regional Health Authority	0
Northern Regional Health Authority	0
Southern Health	0
Saskatchewan South	0
Saskatchewan Central	0
Saskatchewan North	0
South Zone	0
Calgary Zone	0
Central Zone	0
Edmonton Zone	1
North Zone	0
British Columbia	0
Yukon	0
Northwest Territories	0
Nunavut	0
Footnote * Active cases or outbreaks are those in which the onset date of the most recent case/outbreak-associated case falls within 32 days of the issue date of this report^{Footnote 4}. Return to first footnote * referrer

Laboratory summary

Measles

In 2019, forty-three (43) cases of measles have been genotyped and the genotypes were B3 (n=14) and D8 (n=29), both of which are circulating globally.

In week 20, three measles cases were genotyped. All cases had rash onset in epidemiological week 19.

Two cases were genotype D8 and identical to the WHO named strain MVs/Gir Somnath.IND/42.16/ (GenBank accession number KY120864), which is circulating globally. One of these cases was reported by the province of New Brunswick, linked to an earlier case, while the second case was reported by the province of Ontario with travel history to the United States.

The third case genotyped in week 20 was reported by the province of Ontario and had travel history to the Philippines. It was genotype B3 which has been previously imported into Canada from the Philippines in 2019.

**Figure 3: Distribution of measles genotypes detected in 2019 (n=43) by week† of rash onset.**

**Figure 3: Distribution of measles genotypes detected in 2019 (n=43) by week^{Figure 3 - Note †} of rash onset.**
Epi week	B3	B3 - Harare	D4	D8	D8 - Taunton	D9	H1	Total
1	0	0	0	0	0	0	0	0
2	1	0	0	0	0	0	0	1
3	0	0	0	0	0	0	0	0
4	0	0	0	1	0	0	0	1
5	1	0	0	2	0	0	0	3
6	0	0	0	2	0	0	0	2
7	1	0	0	2	0	0	0	3
8	3	0	0	3	0	0	0	6
9	2	0	0	2	0	0	0	4
10	0	0	0	2	0	0	0	2
11	0	0	0	1	0	0	0	1
12	1	0	0	1	0	0	0	2
13	2	0	0	4	0	0	0	6
14	0	0	0	3	0	0	0	3
15	1	0	0	2	0	0	0	3
16	0	0	0	0	0	0	0	0
17	0	0	0	2	0	0	0	2
18	1	0	0	0	0	0	0	1
19	1	0	0	2	0	0	0	3
20	0	0	0	0	0	0	0	0
21	0	0	0	0	0	0	0	0
22	0	0	0	0	0	0	0	0
23	0	0	0	0	0	0	0	0
24	0	0	0	0	0	0	0	0
25	0	0	0	0	0	0	0	0
26	0	0	0	0	0	0	0	0
27	0	0	0	0	0	0	0	0
28	0	0	0	0	0	0	0	0
29	0	0	0	0	0	0	0	0
30	0	0	0	0	0	0	0	0
31	0	0	0	0	0	0	0	0
32	0	0	0	0	0	0	0	0
33	0	0	0	0	0	0	0	0
34	0	0	0	0	0	0	0	0
35	0	0	0	0	0	0	0	0
36	0	0	0	0	0	0	0	0
37	0	0	0	0	0	0	0	0
38	0	0	0	0	0	0	0	0
39	0	0	0	0	0	0	0	0
40	0	0	0	0	0	0	0	0
41	0	0	0	0	0	0	0	0
42	0	0	0	0	0	0	0	0
43	0	0	0	0	0	0	0	0
44	0	0	0	0	0	0	0	0
45	0	0	0	0	0	0	0	0
46	0	0	0	0	0	0	0	0
47	0	0	0	0	0	0	0	0
48	0	0	0	0	0	0	0	0
49	0	0	0	0	0	0	0	0
50	0	0	0	0	0	0	0	0
51	0	0	0	0	0	0	0	0
52	0	0	0	0	0	0	0	0
Total	14	0	0	29	0	0	0	43
Footnote † Epidemiological weeks for laboratory specimens submitted to the National Microbiology Laboratory are assigned and reported in accordance with WHO guidelines (WHO.WER.2012;9(87):73) with week 1 beginning on the first Monday of the year, which for 2019 is January 7. However, for the purposes of this report, the genotype data is presented in accordance with PAHO reporting weeks with week 1 of 2019 beginning on December 30, 2018). Return to footnote † referrer

The current global distribution of measles genotypes can be found on the WHO Measles Surveillance website.

For information regarding the interpretation and use of measles genotyping (including a discussion of genotypes and named strains), refer to Hiebert J and Severini A. Canada Communicable Disease Report. 2014; 40-12: 257-260.

Footnote 1

Active cases or outbreaks are those in which the onset date of the most recent case/outbreak-associated case falls within 32 days of the issue date of this report.

Return to footnote 1 referrer

Footnote 2

Only cases with rash onset up to the indicated end date are included in this report. Any additional cases will be described in future reports.

Return to footnote 2 referrer

Footnote 3

Epidemiological week of birth is used for congenital rubella syndrome cases.

Return to footnote 3 referrer

Footnote 4

Public Health Agency of Canada. Guidelines for the prevention and control of measles outbreaks in Canada. Canadian Communicable Disease Report. 2013. Vol. 39: Definitions: conclusion of an outbreak (p. 5).

Return to footnote 4 referrer

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Date modified:: 2020-01-23

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