Infectious disease specialist Dr. Craig Jenne joins Alberta Primetime to discuss the increasing number of measles cases in Alberta.
This interview has been edited for clarity and length.
Michael Higgins: Alberta’s health minister is now endorsing the measles vaccine, as cases of the infectious disease continue to be identified in the province.
What’s your read on why we have this sudden resurgence when it’s been off the radar for so long?
Dr. Craig Jenne: Unfortunately, I think we’ve been anticipating this coming.
We’ve seen over the past several years – really almost a decade now - of declining vaccination rates. Measles being one of the most infectious diseases out there, takes advantage of those numbers.
Just for reference, we need more than 90 per cent of the population - closer to 95 per cent - vaccinated for herd immunity. As we’ve seen, the numbers are nowhere near those levels in the province of Alberta.
MH: What is this illness? What makes it so highly contagious?
CJ: This is a viral illness. This is a respiratory virus that spreads through the air – and because it is so infectious, this spreads widely.
There’s a lot of evidence saying that somebody can go into a shop or store and even an hour or more later, the air still contains viral particles that can infect an unvaccinated person. So this is something that, once it arrives, becomes very, very difficult to contain.
With the recent outbreaks in Europe, Eastern Canada and the southern US, it was really a matter of time before cases arrived in the province.
MH: And this is not just a rash – the complications can be considerable?
CJ: Absolutely. We do see, unfortunately, a high percentage of kids often requiring hospitalization - some requiring breathing support in the intensive care unit.
As we’ve seen in Ontario in the current outbreak starting last year, they lost a child under the age of five. In the southern U.S., since the new year, they’ve lost one child and one adult.
So it is a disease that can be fatal to some people.
MH: In terms of being contagious, how many people can one person potentially infect, depending on exposure?
CJ: Each person can infect dozens. It really depends on the exposure, it depends on the individuals in their vicinity. Are they vaccinated, partly vaccinated, full vaccinated? It has a dramatic effect on how well this virus spreads and how easy it is to contain it.
MH: How important is it for Alberta’s health minister to now encourage Albertans to get vaccinated?
Just last week, Adriana LaGrange stopped short of recommending immunization, saying it’s up to parents to decide.
CJ: This is something that we really need to see better advocacy for. In the past, this had always been the job of your family doctor. When you brought kids in for their annual checkup, you would get reminded about vaccines and whether the children were receiving vaccines on time.
When we look at the numbers, there’s a substantial proportion of Albertans who do not have a family doctor anymore - and having discontinuous care at walk in clinics or presenting in emergency rooms really doesn’t give your doctor a chance to talk to you about these other questions.
We really do need to see better advocacy. We need to see that information, not just where you can go look it up, but actively presented to parents into people so that they know the importance of vaccination, and also how to get vaccinated.
MH: Whose shoulders should that rest on? Is that the medical community, is that our politicians?
CJ: There’s plenty of work to go around. It’s important to encourage Albertans if they have questions - if they do not think they’ve been vaccinated, for example, or can’t access the records - to talk to a healthcare provider and determine what’s the best approach for them and how to get back on schedule.
We do know that the measles vaccine has been used for decades in Canada. It is highly effective and it is very safe. For the last several decades, it has eradicated measles from Canada. With declining vaccine rates, unfortunately, that disease of the past is back.
MH: If you don’t have your vaccination records, don’t have access to it – is it okay to go out and get vaccinated again?
CJ: It is safe to receive another vaccine, although this is again a conversation for you and a personal healthcare provider. Each person has a different medical history. In some cases, it may be advisable to check antibody levels in your blood - so a quick blood test to determine whether you do have memory to measles.
If not, it is safe to receive an additional dose of the vaccine, if there are questions about whether you’re fully vaccinated or not.
MH: So it’s early days – but what could that potentially grow to?
How worrisome a development is this for our province, where the entirety of Alberta’s health care system is concerned?
CJ: I look to Ontario, Quebec, New Brunswick. I look to Texas and New Mexico, and both of those outbreaks are now well over 300 patients.
The fact that we have four separate introductions of the virus into the province - in the north, in the Edmonton zone, in Calgary and in the south zone - means we are now containing four different exposure groups.
We are concerned that there’s no guarantee it is going to spread, and hopefully contact tracing has identified the risks. But the fact that we have four separate challenges in the province means we are going to be watching very closely for the next couple of weeks to see, unfortunately, if this takes off or not.
MH: Does it matter whether these cases are in rural areas or urban areas?
CJ: It doesn’t - it really matters more what the vaccine status is in that community, what are the potential exposures?
Whether you’re in an urban area and you self isolate when you have symptoms and call 811, and get advice - that way, it’s protective. If you’re in a rural area, but end up going to large supermarkets or gatherings, it can still spread even in the rural areas.
It really depends on the status and how people respond to once they detect symptoms.
We do encourage people to call 811, rather than present at a medical center.
