Measles in Edmonton: The resurgence and how we can tamp it back down (2024)

By the time the blotchy red rash appears from the ears and the face to the trunk and arms and legs —three to seven days after the fever starts — containing measles is an important afterthought.

There is no treatment for the airborne disease. Just prevention. But now some unimmunized Edmontonians are at risk after a child came through the international arrivals gate at Edmonton International Airport on April 16.

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It’s the second such case in six months.

What is measles?

Also known as rubeola, these days measles is typically imported by an unimmunized traveller who, thinking they just have a cold, unwittingly can spread the virus to other unimmunized people around them.

Who can then spread it further.

It can take up to two weeks to fully engage in an affected individual.

In the early stages, cold-like symptoms make a body miserable: high fever, cough, runny nose, red eyes.

“Measles can easily be missed, unfortunately, because by the time the rash comes out, there might have been at least a few to several days of being potentially infectious before it’s recognizable,” said Dr. Lynora Saxinger, a virologist at the University of Alberta.

Those at highest risk include the very young, pregnant women, and immune-compromised individuals, many of whom can’t be immunized and so are protected only by the herd immunity of those around them.

More than just measles

Alberta Health Services (AHS) said one in 10 measles cases results in middle ear or lung infections.

One in a thousand sufferers contract encephalitis, which can lead to seizures, deafness or brain damage.

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Two to three of every thousand measles patients will die.

In 1963, prior to widespread immunization, there were 60,000 cases of measles in Canada, so there could have been up to 180 deaths.

There is also the extremely rare and fatal subacute sclerosing panencephalitis (SSPE), which can suddenly attack years after measles first strikes.

Ask Dr. Joan Robinson, an Edmonton pediatric infectious diseases physician at the Stollery Children’s Hospital, one of the doctors who has seen the deadly side effect up close.

“It’s a very severe complication that is always lethal. Now it’s incredibly rare but it can happen years after you had the measles,” she said.

Robinson’s reluctant to talk about SSPE because it’s so unusual. “I’ve only seen one case of SSPE in my life,” she said.

In that case, it was an unimmunized boy who travelled from the Philippines and had measles earlier in his life.

Stricken years later by the measles aftermath of SSPE, he eventually stopped talking and doing normal things, and finally died.

Vaccination gaps

There are measles cases in Europe and America, but they’re particularly hard on Third World countries, where vaccination coverage isn’t necessarily consistent.

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“It’s not like a mild infection for everyone,” Robinson said. “If you get severe pneumonia, we can keep you alive in intensive care and you are probably going to survive.”

Coming down with measles in sub-Saharan Africa could result in a very different prognosis.

Another atypical but severe complication is encephalitis, an inflammation of the brain, often leading to severe neurological damage, inability to walk or talk.

Years ago, complications from measles could lead to institutionalization.

What to do if at risk of infection

The extent of the current outbreak isn’t known yet.

“We don’t really know the number of secondary cases yet. Hopefully it’s small,” said Saxinger.

“And then of course, you’re trying to contact trace to prevent secondary cases because people who have been in contact might be able to get a vaccine, for example, or an immune and antibody treatment to reduce risk if they’re high risk.”

People who were in these places within the specific time windows should review their immunization records:

• April 16, Edmonton International Airport, 3:20-6 pm;

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• April 20, Stollery Children’s Hospital ER, 5 a.m. to 3 p.m.;

• April 22, 66th Medical Clinic, 12:15-3:30 pm;

• April 23, Stollery Children’s Hospital ER, 4:40 a.m. to 9:33 a.m.

“Anyone who attended these locations at these times who was born in or after 1970 and has less than two documented doses of measles-containing vaccine, is at risk for developing measles,” reads the recent Alberta Health Services alert.

Individuals born before 1970 have probably had measles.

Those who are pregnant, under a year old or have a weakened immune system are most at risk, and should contact Health Link at 1-877-720-0707 as they may be eligible for medication to prevent measles.

If symptoms develop, people are advised to call Health Link 811 before visiting a health care provider.

Debunked myths persist

Robinson said theories about links between vaccinations and other ailments such as autism have long since been debunked, but repeated circulation of the ideas prompts some families to hesitate before vaccination.

The initial “connection” was made because of the timing of initial vaccination and diagnosis of autism coinciding, with the rate of diagnosis increasing because of increased awareness within the medical community.

Robinson compares it to other leaps in logic.

“If you get your hair done and then you get in a car accident, did getting your hair done cause the accident?”

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