Measles & Rubella Weekly Monitoring Report: March 29 to April 4, 2015 (week 13)

Key Points

In Canada, 3 new cases of measles were reported by British Columbia during week 13.
Two provinces (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 (B3 from USA, and H1 from China, respectively).
A total of 183 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=183) 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 04 2015.

Figure 1. Number of cases of measles (n=183) 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 04 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	16	0
12	4	0
13	2	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)	183	0

During epidemiological week 13, 2015, 3 new cases of measles were reported by British Columbia. Rash onsets for these cases occurred in week 12 (n=1) and week 13 (n=2). Recent cases in British Columbia have been linked to travel to China. Conversely, cases in Quebec have primarily been reported in a non-immunizing religious community, linked to travel to the USA.

The year-to-date total is 183 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	0	0
Centre-du-Québec	158	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	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	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, 43 measles cases have been genotyped and the genotypes were: B3 (n=20), D4 (n=17), H1 (n=4) and D8 (n=2).

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.

Four cases from British Columbia were genotype H1 which is endemic in China^{Footnote 2}, consistent with travel and exposure history for these cases.

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.

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	0	1	1
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	2	4	43

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:: 2015-04-15

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