Measles & Rubella Weekly Monitoring Report: April 5 to April 11, 2015 (week 14)

Key Points

  • In Canada, during week 14, 8 new cases of measles were reported, by British Columbia (n=6) and Quebec (n=2). One imported case of rubella was reported by Ontario.
  • 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 191 cases of measles, and 1 case of rubella have been reported in Canada for 2015.

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Date published: 2015-04-22

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Epidemiological Summary

Figure 1. Number of cases measles (n=191) and rubella (n=1), 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 11, 2015.

Figure 1
Figure 1 - Text Description
Figure 1. Number of cases measles (n=191) and rubella (n=1), 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 11, 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 1
13 7 0
14 2 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) 191 1


During epidemiological week 14, 2015, 8 new cases of measles were reported, by British Columbia (n=6) and Quebec (n=2). Rash onsets for these cases occurred in week 11 (n=2), week 13 (n=5) and week 14 (n=1). 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.

One imported case of rubella was reported in Ontario, with rash onset during week 12.

The year-to-date total is 191 cases of measles and 1 case 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 2A: Distribution of confirmed measles and rubella cases by health region. Cases are included if they are considered activeFigure 2A - Footnote * Figure 2A - Footnote ¥ Figure 2A - Footnote

Figure 2A
Figure 2A and 2B: Distribution of confirmed measles and rubella cases by health region. Cases are included if they are considered active.Table Figure 2A - Footnote * Table Figure 2A - Footnote ¥ Table Figure 2A - Footnote
Health Region Measles Cases Rubella Cases
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 1 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 1
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


Figure 2B: Distribution of confirmed measles and rubella cases by health region. Cases are included if they are considered activeFigure 2B - Footnote * Figure 2B - Footnote ¥

Figure 2B
Figure 2A and 2B: Distribution of confirmed measles and rubella cases by health region. Cases are included if they are considered activeTable Figure 2B - Footnote * Table Figure 2B - Footnote ¥
Health Region Measles Cases Rubella Cases
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 1 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 1
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, 48 measles cases have been genotyped and the genotypes were: B3 (n=20), D4 (n=17), H1 (n=9) 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.

Nine cases from British Columbia were genotype H1 which is endemic in ChinaFootnote 2, consistent with travel and exposure history for these cases. All nine cases had N-450 sequences identical to the MVs/Hong Kong.CHN/49.12 sequence variant (GenBank accession number KC417295).

Figure 3: Distribution of measles genotypes detected in 2015 (n=48) by week of rash onset (if available, n=48) 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

* Genotype B3 sequences identical to sequence variant MVi/Harare.ZWE/38.09 (GenBank accession number JF973033)

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 B3 - Harare D4 D8 D8 - Taunton D9 H1 Total
1 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0
3 0 1 1 0 0 0 0 2
4 0 4 7 0 0 0 0 11
5 0 0 1 1 0 0 0 2
6 0 0 7 0 0 0 0 7
7 0 1 1 0 0 0 0 2
8 0 3 0 0 0 0 0 3
9 0 10 0 0 0 0 0 10
10 0 0 0 1 0 0 0 1
11 0 1 0 0 0 0 2 3
12 0 0 0 0 0 0 1 1
13 0 0 0 0 0 0 6 6
14 0 0 0 0 0 0 0 0
15 0 0 0 0 0 0 0 0
16 0 0 0 0 0 0 0 0
17 0 0 0 0 0 0 0 0
18 0 0 0 0 0 0 0 0
19 0 0 0 0 0 0 0 0
20 0 0 0 0 0 0 0 0
21 0 0 0 0 0 0 0 0
22 0 0 0 0 0 0 0 0
23 0 0 0 0 0 0 0 0
24 0 0 0 0 0 0 0 0
25 0 0 0 0 0 0 0 0
26 0 0 0 0 0 0 0 0
27 0 0 0 0 0 0 0 0
28 0 0 0 0 0 0 0 0
29 0 0 0 0 0 0 0 0
30 0 0 0 0 0 0 0 0
31 0 0 0 0 0 0 0 0
32 0 0 0 0 0 0 0 0
33 0 0 0 0 0 0 0 0
34 0 0 0 0 0 0 0 0
35 0 0 0 0 0 0 0 0
36 0 0 0 0 0 0 0 0
37 0 0 0 0 0 0 0 0
38 0 0 0 0 0 0 0 0
39 0 0 0 0 0 0 0 0
40 0 0 0 0 0 0 0 0
41 0 0 0 0 0 0 0 0
42 0 0 0 0 0 0 0 0
43 0 0 0 0 0 0 0 0
44 0 0 0 0 0 0 0 0
45 0 0 0 0 0 0 0 0
46 0 0 0 0 0 0 0 0
47 0 0 0 0 0 0 0 0
48 0 0 0 0 0 0 0 0
49 0 0 0 0 0 0 0 0
50 0 0 0 0 0 0 0 0
51 0 0 0 0 0 0 0 0
52 0 0 0 0 0 0 0 0
Total 0 20 17 2 0 0 9 48


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

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