Measles & Rubella Weekly Monitoring Report – Week 10: March 3 to March 9, 2024

Organization: Public Health Agency of Canada
Date published: 2024-03-21

Key points:

  • In Canada, 9 new cases of measles and no new cases of rubella were reported in week 10, 2024.
  • Currently, there are 24 activeFootnote 1 cases of measles and 2 active cases of congenital rubella syndrome/infection in Canada.
  • 26 cases of measles and 1 case of congenital rubella syndrome/infection have been reported in Canada in 2024.
  • Canadians travelling outside of Canada are encouraged to consult the travel health notices for information on measles and rubella outbreaks occurring in other countries.

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Epidemiological summary

During epidemiological week 10, 2024, 9 new cases of measles and no new cases of rubella were reported in CanadaFootnote 2. 6 cases were reported by the province of Quebec: 1 case was epidemiologically linked to a travel related case with recent travel to Morocco; and 5 cases acquired the infection in Quebec. 3 were children and 3 were adults. Of these 6 cases, 5 were not fully vaccinated or unvaccinated and 1 had an unknown vaccination status. 5 cases had rash onset in epidemiological week 9 or 10, and 1 case did not have any rash.

3 cases were reported by the province of Ontario: 2 cases were imported with recent travel to Mexico and India; and 1 case had an unknown source of exposure. 2 were adults and 1 was a child. Of these 3 cases, 2 were unvaccinated and 1 was vaccinated. All cases had rash onset in epidemiological week 10.

To date in 2024, 26 cases of measles and 1 case of congenital rubella syndrome/infection have been reported. The last case of rubella was reported in September 2023.

Figure 1. Number of cases of measles (n=26), rubella (n=0), and congenital rubella syndrome/infection (n=1)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 March 9, 2024.
Figure 1. Text version below.
Figure 1 - Text description
Epidemiological Week of Rash Onset, 2024 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 1 0 0
4 0 0 0
5 1 0 0
6 1 0 1
7 2 0 0
8 3 0 0
9 10 0 0
10 7 0 0
Cases (year-to-date) 26 0 1

Geographic distribution

There are currently 24 activeFootnote * cases of measles and 2 activeFootnote ** cases of congenital rubella syndrome/infection in Canada.

Figure 2. Distribution of activeFootnote *, confirmed measles cases by health region.
Figure 2. Text version below.
Figure 2 - Text description
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 1
Montréal et Laval 15
Ouest-du-Québec 0
Montérégie 0
Nord-Est 0
Ontario Central East 3
Ontario Central West 2
Ontario Eastern 0
Ontario North East 0
Ontario North West 0
Ontario South West 1
City of Toronto Health Unit 1
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
Figure 3. Distribution of activeFootnote **, confirmed congenital rubella syndrome/infection casesFootnote 4 by health region.
Figure 3. Text version below.
Figure 3 - Text description
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 1
Centre-du-Québec 0
Montréal et Laval 0
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 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 0
Yukon 0
Northwest Territories 0
Nunavut 0
Footnote *

Active measles cases are those in which the onset date of the case falls within 42 days of the end date of the epidemiological week of the report. The Centers for Disease Control and Prevention. Manual for the Surveillance of Vaccine-Preventable Diseases. Chapter 7: Measles. https://www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html. Page last reviewed: May 13, 2019.
Active rubella cases are those in which the onset date of the case falls within 46 days of the end date of the epidemiological week of the report. The Centers for Disease Control and Prevention. Manual for the Surveillance of Vaccine-Preventable Diseases. Chapter 14: Rubella. https://www.cdc.gov/vaccines/pubs/surv-manual/chpt14-rubella.html. Page last reviewed: May 18, 2018.

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Footnote **

Infants with CRS are considered infectious until they are at least 1 year old or until 2 clinical specimens obtained 1 month apart are negative for rubella virus by RT-PCR, either real-time or conventional; culture is also acceptable.

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Laboratory summary

Measles

During epidemiological week 10, 2024, the measles genotype was identified for 11 cases that were reported in epidemiological weeks 9 and 10: 9 cases reported by the province of Quebec; 1 case reported by the province of British Columbia; and 1 case reported by the province of Ontario. 8 cases reported in Quebec were epidemiologically linked to travel related case with recent travel history to Mauritania (all genotype B3), and 1 case was an imported case with recent travel history to Morocco (genotype B3). The case reported in British Columbia was an imported case with recent travel history to Uzbekistan (genotype B3). The case reported in Ontario had an unknown source of exposure and was genotype D8. Overall, genotype D8 was detected in 1 case and genotype B3 in 10 cases.

To date in 2024, 18 cases of measles have been genotyped; 14 were B3 and 4 were D8.

Figure 4: Distribution of measles genotypes detected in 2024 (n=18) by weekFootnote of rash onset.
Figure 4. Text version below.
Figure 4 - Text description
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 1 0 0 0 1
3 0 0 0 1 0 0 0 1
4 0 0 0 0 0 0 0 0
5 1 0 0 0 0 0 0 1
6 1 0 0 0 0 0 0 1
7 2 0 0 0 0 0 0 2
8 2 0 0 1 0 0 0 3
9 8 0 0 1 0 0 0 9
10 0 0 0 0 0 0 0 0
Total 14 0 0 4 0 0 0 18
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 2024 is January 1. However, for the purposes of this report, the genotype data is presented in accordance with PAHO reporting weeks with week 1 of 2024 beginning on December 31, 2023.

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. URL : :https://www.canada.ca/fr/sante-publique/services/rapports-publications/releve-maladies-transmissibles-canada-rmtc/numero-mensuel/2014-40/rmtc-volume-40-12-12-juin-2014/rmtc-volume-40-12-12-juin-2014-1.html

The current global distribution of measles genotypes can be found on the WHO Measles Surveillance website. URL: https://www.who.int/teams/immunization-vaccines-and-biologicals/immunization-analysis-and-insights/surveillance/monitoring/provisional-monthly-measles-and-rubella-data

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Footnotes

Footnote 1

Active measles cases are those in which the onset date of the case falls within 42 days of the end date of the epidemiological week of the report. Active rubella cases are those in which the onset date of the case falls within 46 days of the end date of the epidemiological week of the report.

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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.

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Footnote 3

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

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Footnote 4

The active congenital rubella syndrome case in Ontario (Central West) was initially reported in Saskatchewan.

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