Measles & Rubella Weekly Monitoring Report – Week 28: July 7 to July 13, 2019

On this page

• Epidemiological Summary
• Geographic Distribution
• Laboratory Summary

Epidemiological Summary:

During epidemiological week 28, 2019 four new confirmed cases of measles and no new cases of rubella were reported in Canada^{Footnote 2}. All four cases were reported by the province of Quebec, and are part of an ongoing outbreak in the greater Montreal area that began in June 2019. Rash onset occurred in epidemiological week 28 for all four cases. To date in 2019, 81 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 - Text Equivalent

Figure 1: Number of cases of measles (n=81), 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 July 13, 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	3	0	0
21	7	0	0
22	6	0	0
23	0	0	0
24	3	0	0
25	2	0	0
26	3	0	0
27	1	0	0
28	4	0	0
Cases (year-to-date)	81	0	0

Geographic Distribution

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

Figure 2 - Text Equivalent

Figure 2: Distribution of active^{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	6
Ouest-du-Québec	1
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	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	0
North Zone	0
British Columbia	1
Yukon	0
Northwest Territories	0
Nunavut	0

Laboratory Summary

Measles

In 2019, sixty-four (64) cases of measles have been genotyped and the genotypes were B3 (n=16) and D8 (n=48), both of which are circulating globally.

In week 28, two measles cases were genotyped. Both cases were reported by the province of Quebec. One case, with rash onset in epidemiological week 26, was linked to a previously reported case and had the same measles genotype D8 strain as the earlier case, identical to the WHO named strain MVs/Gir Somnath.IND/42.16/ (GenBank accession number KY120864). A different genotype D8 strain was identified in the second case, who had rash onset in in epidemiological week 25 and travel history to Vietnam.

Figure 3 - Text Equivalent

Figure 3: Distribution of measles genotypes detected in 2019 (n=64) by week ^{Footnote †} 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	2	0	0	0	0	0	0	2
19	1	0	0	2	0	0	0	3
20	0	0	0	2	0	0	0	2
21	0	0	0	5	0	0	0	5
22	0	0	0	5	0	0	0	5
23	0	0	0	0	0	0	0	0
24	0	0	0	3	0	0	0	3
25	1	0	0	1	0	0	0	2
26	0	0	0	3	0	0	0	3
27	0	0	0	0	0	0	0	0
Total	16	0	0	48	0	0	0	64
Footnote 5 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.