Measles & Rubella Weekly Monitoring Report: March 1 to March 7, 2015 (week 9)

Key Points

In Canada, 89 new cases of measles were reported by Quebec during week 09.
Two provinces have reported recent measles activity; these events are not linked as the genotypes are different (D4 in Ontario, B3 in Quebec).
A total of 140 cases of measles, and 0 cases of rubella have been reported in Canada for 2015.

Epidemiological Summary

Figure 1. Number of cases measles (n=140) 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 March 07, 2015.

Figure 1. Number of cases measles (n=140) 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 March 07, 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	14	0
9	79	0
10	0	0
11	0	0
12	0	0
13	0	0
14	0	0
15	0	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)	140	0

During epidemiological week 09, 2015, 89 new cases of measles were reported by Quebec. Rash onset for these cases occurred during week 07 (n=4), week 08 (n=6) and week 09 (n=79). To date, cases in Quebec have primarily been reported in a non-immunizing religious community.

The year-to-date total is 140 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 *}**
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
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	0	0
Centre-du-Québec	121	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	10	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	0	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	0	0
British Columbia Fraser	0	0
British Columbia Vancouver Coastal	0	0
British Columbia Vancouver Island	0	0
British Columbia Northern	0	0
Yukon	0	0
Northwest Territories	0	0
Nunavut	0	0

Laboratory Summary

Measles

To date in 2015, 26 measles cases have been genotyped and the genotypes were: D4 (n=17), B3 (n=8) and D8 (n=1).

Of the 18 reported measles cases in Ontario, 17 cases have been genotyped. All have an identical genotype D4 strain, based on the standard N-450 sequence.

From Quebec, 8 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.

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

The current global distribution of measles genotypes can be found on the WHO Measles Nucleotide Surveillance (MeaNS) 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

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Date modified:: 2015-03-18

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