Alberta in the midst of worst measles outbreak since 1997 as doctors call for action

Alberta's measles outbreak is now the worst recorded in nearly three decades and that has health experts raising the alarm and renewing calls for stronger messaging from the provincial government.

The surge is so concerning, Alberta's former chief medical officer of health, Dr. Mark Joffe, who left his post less than two weeks ago, is speaking out and describing measles as a "horrid illness."

With 129 cases confirmed as of midday Thursday, the case counts so far this year have already surpassed the most recent high in the year 2000, when 123 cases were reported.

The previous major peak was in 1997, when there were 242 cases. In most other years, in the decades after widespread measles vaccination was introduced, only a handful of cases have been reported.

"Working in a hospital and seeing sick kids — when you see something that is preventable — it's just a shame to have a child come in and suffer from that," said Dr. Sidd Thakore, a pediatrician working at Alberta Children's Hospital in Calgary.

"We're seeing the end result of vaccination rates dropping." 

In Edmonton, Dr. Joan Robinson calls Alberta's measles situation "alarming."

"We have failed in our mission to get this outbreak under control," said Robinson, the director of the pediatric infectious diseases division at the University of Alberta.

"With that many cases it is, I think, impossible that we can shut this all down without there being significant further spread."

In an opinion piece, published Thursday in the Calgary Herald, Joffe wrote at length about the dangers of measles.

"Alberta's current outbreak of measles, affecting mostly children, should concern us all," he said, noting that between 10 and 20 per cent of people infected will require hospital admission.

"Measles is a horrid illness. It is much more severe than most childhood infections. While most people recover, some don't."

Measles can lead to serious complications, including pneumonia, brain swelling and even death.

This marks the first time Albertans have heard from Joffe since he left the interim CMOH position earlier this month when his contract ended. The Premier noted at the time that the government wanted him to stay on as chief medical officer of health.

His departure came on the heels of  growing calls for him to take to the podium and speak directly to Albertans about outbreaks. And doctors raised questions about whether he was allowed to do so.

The provincial government has since appointed a temporary replacement.

CBC News asked this week for an interview with the interim CMOH, Dr. Sunil Sookram, but was told he is unavailable.

Health Minister Adriana LaGrange shared Joffe's opinion piece on X, formerly known as Twitter, and thanked him for highlighting the importance of measles vaccination.

"Alberta's government takes public health seriously, and if you want more information on measles or check your immunization record, please contact your local public health centre, call 811, or text 'measles'/'vaccine record' to 88111," LaGrange said in the social media post.

Outbreaks will continue doctors warn

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

"There's so many areas with very low levels of immunization so you know that the risk in that population is not small," said Dr. Jim Kellner, a pediatrician and infectious diseases specialist at Alberta Children's Hospital.

"Without being overly dramatic, you can anticipate that we're going to see hundreds of more cases this year. And that's a pretty dramatic change from almost no cases." 

Measles is a highly contagious airborne virus and people can be infectious before they show symptoms, making it extremely difficult to contain without adequate population level protection through vaccination, said Kellner.

The latest publicly available data shows that, as of April 19, nine Albertans had been hospitalized since the outbreaks began.

"If you have enough cases, you're going to see these rare, severe complications including death," said Kellner, noting there is no effective anti-viral drug to treat measles.

Measles vaccine uptake started dropping before the pandemic and continued to decline in the years following, he said. Some parts of Alberta now have very low rates.

Calls for messaging, mass immunization clinics

What's missing, he argues, is strong messaging from public health officials encouraging vaccination and sharing key information about measles and its risks.

"They've been silent on that. There have not been any kind of efforts to provide increased accessibility to vaccine or even recommendations for it," said Kellner, who's also a professor of pediatrics at the University of Calgary.

"It's worrisome because then if there's nothing that happens officially, that doesn't lead to confidence by the general public."

• Measles outbreaks spark concern over rare 'horrific' neurological disorder

Kellner noted approximately 100,000 children die every year globally due to measles.

"It's still a major affliction in childhood especially — but even in older persons — around the world. And the No. 1 thing to do is get vaccine rates up."

Thakore echoes Kellner's concerns.

"We need leadership. We need the public to be able to hear from someone in a leadership position, which is the medical officer of health," he said.

Robinson is calling on the province to set up widespread drop-in immunization clinics.

"So that people can show up without appointments and get themselves or their children's [immunizations] updated," she said.

"We do not have the resources for that in public health right now. But if the government made that a priority, we could make that happen over the next week, even."

• Alberta wanted chief medical officer of health to remain in job, premier says
• Alberta appoints interim chief medical officer of health as province grapples with measles outbreaks

Meanwhile, in his opinion piece, Joffe said the measles vaccine, which has been used for more than five decades, has a well-established safety record.

And he had a stark warning for Albertans.

Up to two people in every 1,000 measles patients will develop a brain infection, which often leads to chronic disability or death, he said.

A similar number, according to Joffe, will develop long-term brain inflammation, known as subacute sclerosing panencephalitis, which can happen years later and lead to behaviour and cognitive changes and "inevitable death."

"In Alberta in the pre-vaccine 1950s, around 10 people (almost always children) died each year from measles. With our current population, and without immunization, measles would cause 45 to 50 deaths each year in Alberta, mainly in young children."

According to the provincial government's website, between one and three out of every 1,000 people with measles will die.

Measles symptoms include:

• High fever.
• Cough.
• Runny nose.
• Red eyes.
• Blotchy, red rash that appears three to seven days after the fever starts.

Information about measles, including case counts, can be found on the Alberta government's measles web page, which includes a link to a list of exposure location alerts.