Measles & Rubella Weekly Monitoring Report: April 19 to April 25, 2015 (week 16)

Key Points

In Canada, no new cases of measles were reported during week 16.
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.

Epidemiological Summary

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 25, 2015.

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 25, 2015.
Epidemiological Week of Rash Onset, 2015	Number of confirmed measles cases reported	Number of confirmed rubella cases reported
1	0	0
2	1	0
3	3	0
4	12	0
5	2	0
6	13	0
7	16	0
8	15	0
9	87	0
10	12	0
11	17	0
12	4	0
13	8	0
14	1	0
15	2	0
16	0	0
17	0	0
18	0	0
19	0	0
20	0	0
21	0	0
22	0	0
23	0	0
24	0	0
25	0	0
26	0	0
27	0	0
28	0	0
29	0	0
30	0	0
31	0	0
32	0	0
33	0	0
34	0	0
35	0	0
36	0	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)	193	0

During epidemiological week 16, 2015, no new cases of measles were reported.

Recent measles activity reported prior to week 16 includes an imported case in Manitoba (linked to travel to South Africa), and outbreaks in Quebec and British Columbia (linked to travel to India and China, respectively).

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.

Geographic Distribution

Figure 2: Distribution of confirmed measles and rubella cases by health region. Cases are included if they are considered active^{Table Figure 2 - Footnote *} ^{Table Figure 2 - Footnote ¥} ^{Table Figure 2 - Footnote †}
Health Region	Measles Cases	Rubella Cases
Table Figure 2 - Footnote 1 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 Return to Table Figure 2 - Footnote * referrer Table Figure 2 - Footnote 2 'No Data' is indicated for jurisdictions that do report cases of measles or rubella to the Public Health Agency of Canada, but do not include the public health region variable. Return to Table Figure 2 - Footnote ¥ referrer Table Figure 2 - Footnote 3 Two cases of measles in British Columbia have been excluded from the figure. Return to Table Figure 2 - Footnote † referrer
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	2	0
Centre-du-Québec	159	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	1	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 Interior	No Data	No Data
British Columbia Fraser	No Data	No Data
British Columbia Vancouver Coastal	No Data	No Data
British Columbia Vancouver Island	No Data	No Data
British Columbia Northern	No Data	No Data
Yukon	0	0
Northwest Territories	0	0
Nunavut	0	0

Laboratory Summary

Measles

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).

Ten cases from British Columbia were genotype H1 which is endemic in China^{Footnote 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 India^{Footnote 2}.

Figure 3: Distribution of measles genotypes detected in 2015 (n=50) by week of rash onset (if available, n=50) 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.

Figure 3: Distribution of measles genotypes detected in 2015 cases by week of rash onset (if available) or specimen collection. 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.
Epi week	B3 - Harare	D4	D8	H1	Total
1	0	0	0	0	0
2	0	0	0	0	0
3	1	1	0	0	2
4	4	7	0	0	11
5	0	1	1	0	2
6	0	7	0	0	7
7	1	1	0	0	2
8	3	0	0	0	3
9	10	0	0	0	10
10	0	0	1	0	1
11	1	0	0	2	3
12	0	0	0	1	1
13	0	0	1	7	8
14	0	0	0	0	0
15	0	0	0	0	0
16	0	0	0	0	0
17	0	0	0	0	0
18	0	0	0	0	0
19	0	0	0	0	0
20	0	0	0	0	0
21	0	0	0	0	0
22	0	0	0	0	0
23	0	0	0	0	0
24	0	0	0	0	0
25	0	0	0	0	0
26	0	0	0	0	0
27	0	0	0	0	0
28	0	0	0	0	0
29	0	0	0	0	0
30	0	0	0	0	0
31	0	0	0	0	0
32	0	0	0	0	0
33	0	0	0	0	0
34	0	0	0	0	0
35	0	0	0	0	0
36	0	0	0	0	0
37	0	0	0	0	0
38	0	0	0	0	0
39	0	0	0	0	0
40	0	0	0	0	0
41	0	0	0	0	0
42	0	0	0	0	0
43	0	0	0	0	0
44	0	0	0	0	0
45	0	0	0	0	0
46	0	0	0	0	0
47	0	0	0	0	0
48	0	0	0	0	0
49	0	0	0	0	0
50	0	0	0	0	0
51	0	0	0	0	0
52	0	0	0	0	0
Total	20	17	3	10	50

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.

Footnotes

Footnote 1

Public Health Agency of Canada. Guidelines for the prevention and control of measles outbreaks in Canada. Canadian Communicable Disease Report. 2013. Vol. 39: Definitions: conclusion of an outbreak (p. 5).

Return to first footnote 1 referrer

Return to footnote1 referrer

Footnote 2

Rota PA, K Brown, A Mankertz, S Santibanez et al. Global distribution of measles genotypes and measles molecular epidemiology. Journal of Infectious Diseases. 2011:204(Suppl 1);S514-S523.

Return to first footnote 2 referrer

Return to footnote2 referrer

Page details

Date modified:: 2015-05-06

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