Measles & Rubella Weekly Monitoring Report: April 12 to April 18, 2015 (week 15)
- In Canada, during week 15, 2 new cases of measles were reported, by Quebec (n=1) and Manitoba (n=1). A case of rubella previously reported by Ontario was discarded.
- Three provinces (Manitoba, Quebec and British Columbia) have reported recent measles activity. These events are not linked, as they are different genotypes and resulted from separate importation events.
- A total of 193 cases of measles, and 0 cases of rubella have been reported in Canada for 2015.
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Figure 1. Number of cases of measles (n=193) 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 April 18, 2015.
During epidemiological week 15, 2015, 2 new cases of measles were reported, by Quebec (n=1) and Manitoba (n=1). The case reported by Quebec was linked to a case imported from India, whereas the case reported by Manitoba was an imported case related to travel to South Africa.
Recent measles cases reported prior to week 15 include cases in British Columbia which were linked to travel to China, and a large outbreak in a non-immunizing religious community in Quebec which was linked to travel to the United States.
A previously reported case of rubella was reported in Ontario has been discarded, as it was determined to be a false positive.
The year-to-date total is 193 cases of measles and 0 cases of rubella for 2015.
Note that when additional cases are reported in advance of the cycle, these cases will be described in the appropriate reporting cycle.
To date in 2015, 50 measles cases have been genotyped and the genotypes were: B3 (n=20), D4 (n=17), H1 (n=10) and D8 (n=3).
From Quebec, 20 cases were genotyped and were genotype B3, identical to the MVi/Harare.ZWE/38.09 sequence variant (GenBank accession number JF973033), and identical to the virus reported in a multi-state outbreak in the United States.
Ten cases from British Columbia were genotype H1 which is endemic in ChinaFootnote 2, consistent with travel and exposure history for these cases. Nine cases had N-450 sequences identical to the MVs/Hong Kong.CHN/49.12 sequence variant (GenBank accession number KC417295).
One imported case from Quebec, with travel history to India, was genotype D8 which is endemic in IndiaFootnote 2.
Figure 3: Distribution of measles genotypes detected in 2015 (n=43) by week of rash onset (if available, n=43) or specimen collection (n=0). Epidemiological weeks are assigned in accordance with WHO guidelines (WHO.WER.2012;9(87):73) with week 1 beginning on the first Monday of the year.
* Genotype B3 sequences identical to sequence variant MVi/Harare.ZWE/38.09 (GenBank accession number JF973033)
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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