Measles & Rubella Weekly Monitoring Report – Week 36: September 2 to September 8, 2018

Key Points

In Canada, one new case of measles and no cases of rubella were reported in week 36, 2018.
Twenty-three cases of measles and no cases of rubella have been reported in Canada in 2018.
Globally, there are large measles outbreaks reported across Europe which have affected a large number of countries. Canadians travelling to Europe and Venezuela are invited to consult the travel health notices for more information.

Epidemiological summary

During epidemiological week 36, 2018 one new laboratory-confirmed case of measles and no cases of rubella were reported in Canada¹ . The measles case was reported by the province of British Columbia and had rash onset in epidemiological week 36. This case is epidemiologically linked to a case reported in epidemiological week 34.

To date in 2018, a total of 23 cases of measles have been reported. The majority of cases were unique importations and a few of those resulted in transmissions in Canada.

The last rubella case was reported in February 2016.

Figure 1: Number of cases of measles (n=23) 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 September 8, 2018.

Figure 1 - Long Description

Figure 1: Number of cases of measles (n=23) 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 September 8, 2018.
Epidemiological Week of Rash Onset, 2018	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	1	0
7	1	0
8	0	0
9	0	0
10	1	0
11	0	0
12	0	0
13	0	0
14	1	0
15	1	0
16	2	0
17	1	0
18	1	0
19	1	0
20	0	0
21	0	0
22	3	0
23	1	0
24	1	0
25	1	0
26	1	0
27	0	0
28	1	0
29	0	0
30	0	0
31	2	0
32	0	0
33	0	0
34	1	0
35	0	0
36	1	0
37	0	0
38	0	0
39	0	0
40	0	0
41	0	0
42	0	0
43	0	0
44	0	0
45	0	0
46	0	0
47	0	0
48	0	0
49	0	0
50	0	0
51	0	0
52	0	0
Missing Rash Onset	0	0
Cases (year-to-date)	23	0

Geographic distribution

There are currently two active^{Note *} case of measles reported in Canada.

There are no reported active cases of rubella in Canada.

Figure 2: Distribution of active^{Footnote *}, confirmed measles cases by health region.

Figure 2 - Text Description

Figure 2: Distribution of active ^{Figure 2 Table - Footnote *} confirmed measles cases by health region
Health Region	Measles Cases	Rubella Cases
Eastern Regional Integrated Health Authority	0	0
Central Regional Integrated Health Authority	0	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	0	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	0	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	2	0
Yukon	0	0
Northwest Territories	0	0
Nunavut	0	0
Figure 2 Table - 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 2}. Return to Figure 2 Table - Footnote * referrer

Laboratory summary

Measles

In 2018, 20 cases of measles have been genotyped and the genotypes were B3 (n=5) and D8 (n=15) (Figure 3).

Measles genotype D8, identical to the WHO named strain MVs/Osaka.JPN/29.15 (GenBank accession number LC072667), was detected in the case reported by the province of British Columbia with rash onset in epidemiological week 34 and potential exposure at a cruise ship terminal.

Figure 3: Distribution of measles genotypes detected in 2018 (n=20) by week† of rash onset.

Figure 3 - Long Description

**Figure 3: Distribution of measles genotypes detected in 2018 (n=19) by week^{Figure 2 - Note †} of rash onset.**
Epi week	B3	D8	Total
1	0	0	0
2	0	0	0
3	0	0	0
4	0	1	1
5	0	0	0
6	0	1	1
7	0	1	1
8	0	0	0
9	0	0	0
10	0	1	1
11	0	0	0
12	0	0	0
13	0	0	0
14	1	0	1
15	0	0	0
16	2	0	2
17	1	0	1
18	0	1	1
19	0	1	1
20	0	0	0
21	0	0	0
22	0	3	3
23	0	1	1
24	0	1	1
25	1	1	1
26	0	0	0
27	0	1	0
28	0	0	0
29	0	0	0
30	0	0	0
31	0	1	0
32	0	0	0
33	0	0	0
34	0	1	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
Total	5	15	20

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.

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2021-06-18

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