Measles & Rubella Weekly Monitoring Report - Week 23, 2017: June 4 to June 10, 2017

Key Points

  • In Canada, one new case of measles was reported in week 23, 2017.
  • Three provinces (Quebec, Nova Scotia and Newfoundland and Labrador) have active measles cases.
  • A total of 43 cases of measles, and zero cases of rubella have been reported in Canada in 2017.

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Epidemiological summary:

During epidemiological week 23, 2017 one new case of measles was reported in Canada, by Quebec. This case had rash onset in week 21, and is not linked to an ongoing outbreak. This case is likely related an importation event from Bali, as the case might have been exposed to measles at his school at the beginning of his incubation period.

To date in 2017, 43 cases of measles have been reported in Canada. Two outbreaks have been confirmed – one that began in February and has since concluded, and the other is an ongoing outbreak that began in March and involved five provinces.

No cases of rubella have been reported in 2017 (Figure 1). It has been 68 epidemiologic weeks since the last rubella case was reported (week 6, 2016).

Number of cases of measles (n=43) and rubella (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 June 10, 2017.

  • Figure 1 - Long Description
    Number of cases of measles (n=43) and rubella (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 June 10, 2017.
    Epidemiological Week of Rash Onset, 2017 Number of confirmed measles cases reported Number of confirmed rubella cases reported
    1 0 0
    2 0 0
    3 0 0
    4 1 0
    5 0 0
    6 2 0
    7 1 0
    8 4 0
    9 1 0
    10 0 0
    11 1 0
    12 8 0
    13 12 0
    14 1 0
    15 3 0
    16 3 0
    17 1 0
    18 2 0
    19 0 0
    20 1 0
    21 2 0
    22 0 0
    23 0 0
    Missing Rash Onset 0 0
    Cases (year-to-date) 43 0

Geographic distribution

There are currently active* cases of measles reported in three Canadian provinces (Quebec, Nova Scotia and Newfoundland and Labrador) (Figure 2).

There are no reported active cases of rubella in Canada (Figure not shown).

Maps from previous weeks, including any retrospective updates, are available online in the Measles and rubella weekly surveillance maps feature.

Figure 2: Distribution of active*, confirmed measles cases by health region

*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 reportFootnote 2.

  • Figure 2 - Long Description
    Figure 2: Distribution of active*, confirmed measles cases by health region.
    Health Region Measles Cases Rubella Cases
    Eastern Regional Integrated Health Authority 0 0
    Central Regional Integrated Health Authority 1 0
    Western Regional Integrated Health Authority 0 0
    Labrador-Grenfell Regional Integrated Health Authority 0 0
    Prince Edward Island 0 0
    South Shore District Health Authority 0 0
    South West Nova District Health Authority 0 0
    Annapolis Valley District Health Authority 1 0
    Colchester East Hants Health Authority 0 0
    Cumberland Health Authority 0 0
    Pictou County Health Authority 0 0
    Guysborough Antigonish Strait Health Authority 0 0
    Cape Breton District Health Authority 0 0
    Capital District Health Authority 0 0
    Zone 1 (NB) 0 0
    Zone 2 (NB) 0 0
    Zone 3 (NB) 0 0
    Zone 4 (NB) 0 0
    Zone 5 (NB) 0 0
    Zone 6 (NB) 0 0
    Zone 7 (NB) 0 0
    Québec et Chaudières-Appalaches 0 0
    Centre-du-Québec 0 0
    Montréal et Laval 1 0
    Ouest-du-Québec 0 0
    Montérégie 0 0
    Nord-Est 0 0
    Ontario Central East 0 0
    Ontario Central West 0 0
    Ontario Eastern 0 0
    Ontario North East 0 0
    Ontario North West 0 0
    Ontario South West 0 0
    City of Toronto Health Unit 0 0
    Winnipeg Regional Health Authority 0 0
    Prairie Mountain Health 0 0
    Interlake-Eastern Regional Health Authority 0 0
    Northern Regional Health Authority 0 0
    Southern Health 0 0
    Saskatchewan South 0 0
    Saskatchewan Central 0 0
    Saskatchewan North 0 0
    South Zone 0 0
    Calgary Zone 0 0
    Central Zone 0 0
    Edmonton Zone 0 0
    North Zone 0 0
    British Columbia 0 0
    Yukon 0 0
    Northwest Territories 0 0
    Nunavut 0 0

    *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.

Laboratory summary

Measles

To date in 2017, 35 measles cases have been genotyped and the genotypes are B3 (n=6) and D8 (n=29) (Figure 3).

During epidemiological week 23, 2017, 1 new measles genotype result became available for the case reported by Quebec in week 23. It had a genotype D8 sequence that was distinct from the genotype D8 sequence identified in the ongoing multi-jurisdictional outbreak.

Figure 3: Distribution of measles genotypes detected in 2017 (n=35) by week of rash onset.

Epidemiological weeks for laboratory specimens are assigned in accordance with WHO guidelines (WHO.WER.2012;9(87):73) with week 1 beginning on the first Monday of the year.

  • Figure 3 - Long Description
    Figure 3: Distribution of measles genotypes detected in 2017 (n=35) by week 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 0 0 0 0 0 0 0 0
    3 0 0 0 0 0 0 0 0
    4 0 0 0 0 0 0 0 0
    5 0 0 0 0 0 0 0 0
    6 2 0 0 0 0 0 0 2
    7 1 0 0 0 0 0 0 1
    8 2 0 0 2 0 0 0 4
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 2 0 0 0 2
    12 0 0 0 8 0 0 0 8
    13 1 0 0 4 0 0 0 5
    14 0 0 0 3 0 0 0 3
    15 0 0 0 2 0 0 0 2
    16 0 0 0 4 0 0 0 4
    17 0 0 0 0 0 0 0 0
    18 0 0 0 2 0 0 0 2
    19 0 0 0 0 0 0 0 0
    20 0 0 0 1 0 0 0 0
    21 0 0 0 0 0 0 0 0
    22 0 0 0 1 0 0 0 0
    23 0 0 0 0 0 0 0 0
    Total 6 0 0 29 0 0 0 35

    † Epidemiological weeks for laboratory specimens are assigned in accordance with WHO guidelines (WHO.WER.2012;9(87):73) with week 1 beginning on the first Monday of the year.

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 sequence variants), refer to Hiebert J and Severini A. Canada Communicable Disease Report. 2014; 40-12: 257- 260.

Rubella:

To date in 2017, no rubella cases have been genotyped.

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