Measles & Rubella Weekly Monitoring Report – Week 42: October 14 to October 20, 2018 

Key Points

  • In Canada, one new case of measles and no new cases of rubella were reported in week 42, 2018.
  • Twenty-six cases of measles and one case of congenital rubella syndrome 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.

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Epidemiological summary

During epidemiological week 42, 2018 one new laboratory-confirmed case of measles and no new laboratory-confirmed cases of rubella were reported in Canada1 . The measles case was reported by the province of Manitoba, with rash onset having occurred in week 41, and is a close contact of a case reported by Manitoba in week 39.

To date in 2018, a total of 26 cases of measles and 1 case of congenital rubella syndrome have been reported. The majority of measles cases were unique importations and a few of those resulted in transmissions in Canada. The last case of congenital rubella syndrome was reported in epidemiological week 39. This case will continue to be monitored by local public health to prevent risk of further spread.

Figure 1: Number of cases of measles (n=26),  rubella (n=0), and congenital rubella syndrome (n=1)Footnote 2  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 October 20, 2018.

Figure 1 - Long Description
Figure 1: Number of cases measles (n=26), rubella (n=0) and congenital rubella syndrome/infection (n=1), 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 October 20, 2018.
Epidemiological Week of Rash Onset, 2018 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 0 0 0
3 0 0 0
4 1 0 0
5 0 0 0
6 1 0 0
7 1 0 0
8 0 0 0
9 0 0 0
10 1 0 0
11 0 0 0
12 0 0 0
13 0 0 0
14 1 0 0
15 1 0 0
16 2 0 0
17 1 0 0
18 1 0 0
19 1 0 0
20 0 0 0
21 0 0 0
22 3 0 0
23 1 0 0
24 1 0 0
25 1 0 0
26 1 0 0
27 0 0 0
28 1 0 0
29 0 0 0
30 0 0 0
31 2 0 0
32 0 0 0
33 0 0 1
34 1 0 0
35 0 0 0
36 1 0 0
37 1 0 0
38 1 0 0
39 0 0 0
40 0 0 0
41 1 0 0
Missing Rash Onset 0 0 0
Cases (year-to-date) 26 0 1

Geographic distribution

There is currently one active Footnote *  case of measles reported in Canada.

Figure 2: Distribution of activeFootnote *, 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 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) 0
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 0
Ouest-du-Québec 0
Montérégie 0
Nord-Est 0
Ontario Central East 0
Ontario Central West 0
Ontario Eastern 0
Ontario North East 0
Ontario North West 0
Ontario South West 0
City of Toronto Health Unit 0
Winnipeg Regional Health Authority 0
Prairie Mountain Health 0
Interlake-Eastern Regional Health Authority 1
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 0
North Zone 0
British Columbia 0
Yukon 0
Northwest Territories 0
Nunavut 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 reportFootnote 2.

Return to Figure 2 Table - Footnote * referrer

Laboratory summary

Measles

In 2018, 23 cases of measles have been genotyped and the genotypes were B3 (n=5) and D8 (n=18) (Figure 3).

Figure 3: Distribution of measles genotypes detected in 2018 (n=23) by weekFootnote   of rash onset.

 
Figure 3 - Long Description
Figure 3: Distribution of measles genotypes detected in 2018 (n=23) by weekFigure 2 - 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 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0
4 0 0 0 1 0 0 0 1
5 0 0 0 0 0 0 0 0
6 0 0 0 1 0 0 0 1
7 0 0 0 1 0 0 0 1
8 0 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0 0
10 0 0 0 1 0 0 0 1
11 0 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0 0
14 1 0 0 0 0 0 0 1
15 0 0 0 0 0 0 0 0
16 2 0 0 0 0 0 0 2
17 1 0 0 0 0 0 0 1
18 0 0 0 1 0 0 0 1
19 0 0 0 1 0 0 0 1
20 0 0 0 0 0 0 0 0
21 0 0 0 0 0 0 0 0
22 0 0 0 3 0 0 0 3
23 0 0 0 1 0 0 0 1
24 0 0 0 1 0 0 0 1
25 1 0 0 1 0 0 0 1
26 0 0 0 0 0 0 0 0
27 0 0 0 1 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 1 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 1 0 0 0 0
35 0 0 0 0 0 0 0 0
36 0 0 0 1 0 0 0 0
37 0 0 0 1 0 0 0 0
38 0 0 0 1 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
Total 5 0 0 18 0 0 0 23

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

In 2018, there has been one rubella (congenital rubella syndrome) case genotyped and it was genotype 2B.

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