Alberta's measles case counts climb with central zone hardest hit

Alberta is reporting a surge of new measles cases this week, sparking fresh calls for the provincial government to provide more detailed data and for the province's top doctor to appear publicly.

But even as the pressure mounts, health minister Adriana LaGrange is not offering any clear sense about when the chief medical officer of health might speak directly to Albertans about the situation.

The province confirmed nine new cases on Monday, seven additional cases on Tuesday, and another three on Wednesday, bringing the total confirmed during this year's outbreaks to 46.

While outbreaks span all five health zones, the central zone is now the hot spot for transmission, with 22 cases confirmed so far.

As of Tuesday, six Albertans had been hospitalized since the surge began, according to Alberta Health.

"It unfortunately shows that this disease, not only is it highly infectious, it's severe," said Dr. Cora Constantinescu, a pediatrician and infectious diseases specialist working at Alberta Children's Hospital.

Alberta's hospitalization rate, according to Constantinescu, appears similar to that in other jurisdictions with measles outbreaks.

"When you think about the fact that one out of 10 children are going to end up in hospital with this disease, that's a big deal," she said.

"It's a big concern for that family [and] for that child."

The vast majority of Alberta's confirmed cases — 42 out of 46 to date — have been in those under the age of 18.

Alberta's growing wave of cases comes just after Texas reported the death of a second unvaccinated child due to measles. 

There have been no deaths in Alberta connected to these outbreaks, the province confirmed.

Meanwhile, there are new calls for decisive action from the province as measles case counts rise.

The Edmonton Zone Medical Staff Association wants the government of Alberta to immediately provide regular measles updates and release a plan to increase vaccination rates to 95 per cent, the level needed to protect against community transmission.

"I'd like to see the government come out with a strong message for everyone to get immunized," said Dr. Richard Owen, president of the Edmonton zone association.

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 The Alberta government website states two doses of the measles vaccines offers nearly 100 per cent protection.

The Edmonton association is also calling on the province to beef up the data it makes available to the public — modelling it after the respiratory virus dashboard, which provides detailed information about influenza, COVID-19 and RSV.

"There seems to be a sense that this is being downplayed by the government … and I think it's worthy of a more honest response," said Owen, an Edmonton-based radiologist.

As CBC News reported last week, Alberta's chief medical officer of health, Dr. Mark Joffe, has not appeared publicly since the outbreaks began. 

"Is there something to hide? Why would the chief medical officer not be able to speak about a major outbreak … of a disease that was essentially eradicated in Canada?" said Owen.

According to the Public Health Agency of Canada, in 1998 the virus was considered "eliminated" in Canada because endemic transmission was no longer taking place.

Health minister responds

While Alberta Health Minister LaGrange insisted on Tuesday that key efforts are underway to rein in the outbreaks, she stopped short of committing to an appearance by Alberta's top doctor.

"When Dr. Joffe feels that's important for him to do, he will absolutely go out and do it. But right now, he feels it's important to work with the local medical officers of health and the local communities to make sure that those individuals — those communities — are getting the information and the support that they need," said LaGrange.

When asked whether Joffe would be allowed to speak publicly if he wants to, she did not answer.

A statement provided by Alberta Health last week said the current response was considered "appropriate" and "should the situation escalate, and a provincewide outbreak is declared, we anticipate Dr. Joffe speaking more broadly to Albertans."

LaGrange said Joffe is in constant communication with public health officials in all five health zones.

"[He's] working with all of  the medical officers of health to make sure that the information is getting out there," she said, adding the province has launched a measles information campaign.  

According to LaGrange, public health officials are going into impacted communities and conducting contact tracing to prevent further transmission

Immunization status of cases unreported in Alberta

Measles is highly infectious and can lead to ear infections, pneumonia and even swelling of the brain (which can cause brain damage). According to Alberta Health, between one and three of every 1,000 people infected will die.

An Alberta Health Services exposure alert, issued Tuesday, reported that 13 of the central zone cases had been confirmed in Two Hills. That community has some of the lowest vaccination rates in the province, publicly available data shows.

While Alberta updates measles case counts on weekdays, providing a breakdown by zone, it does not share information on immunization status. 

CBC News has asked the province for data on how many measles cases are vaccinated versus unvaccinated, but the information has not been provided.

"I would really like to see the immunization status as well the way that it is communicated in other provinces and the way they communicated it during the pandemic," said Constantinescu, adding the weekday case updates and zone breakdown that is provided is helpful.

"If parents can have any extra information and help to make the decision to immunize their child, we should give it to them." 

Ontario, which is experiencing Canada's largest outbreak, publishes detailed information on its cases, including immunization status.

Its latest update shows 94.4 per cent of cases among babies, children and adolescents were unimmunized. Among adults, it was 62.5 per cent.

Texas also shares this information publicly. Its dashboard shows 471 of its 481 confirmed cases are unimmunized or vaccination history is unknown.

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A spokesperson for Alberta Health told CBC News that public health officials continue to review how information is communicated to the public and changes may be considered in the near future.

Meanwhile, the province has lowered the age at which babies living in central and south zones are eligible for their first measles vaccine (to six months of age). This change was previously put in place for infants in parts of northern Alberta.

Adults born before 1970 who are living in the same parts of the province may also be eligible for a single dose if they meet certain criteria.