Nova Scotia's top health official watching measles cases closely

Public health experts are tracking a growing number of measles cases in European countries like the U.K., Austria and Belgium — that's in spite of widespread availability of vaccines in developed countries.

Measles case rates in Canada are currently much lower than those in Europe or even the U.S., but Nova Scotia Chief Medical Officer of Health Dr. Robert Strang says people should still take steps to protect themselves and their children.

Dr. Strang was interviewed by the CBC's Preston Mulligan for Mainstreet on Monday. This interview has been edited for length and clarity.

What do you make of measles cases popping up in Ontario and Quebec?

What happens in one part of the world affects the other parts of the world. So we're watching this closely and we're taking steps so the Nova Scotia health system is prepared and we need to let Nova Scotians know about the situation and what they should be doing, especially in terms of immunization.

 What should Nova Scotians be doing right now?

We know that people who were born before 1970, they've probably been exposed to measles as children so they probably have natural immunity. But anybody who was born in 1970 or after that, we recommend now that people need to have two doses of measles-containing vaccine to get long-term immunity.

Those would be people who are 54 or younger, they should really look at their immunization information. If they haven't had two doses of measles-containing vaccine, usually MMR or MMRV for varicella, then they're eligible. We recommend that they get that second dose or, if they haven't had any [vaccinations for measles], that they get two doses — especially if they're travelling outside of Canada in the next little while.

If you have a child who is between six and 12 months of age and you're going to travel to a part of the world where there's lots of measles activity, we recommend you take your child to your primary care provider and get that first dose of measles vaccine. You still have to get the 12-month and 18-month shot because if you get immunized early, you don't get long-lasting immunity but it certainly gives you protection for the duration of travel and it's young children that have the highest risk of severe outcomes from measles.

So everybody born from 1970 until now should get the measles vaccine if they haven't yet?

Lots of people who were born in 1970 or after would have had a single dose of the measles vaccine. If you're born in 1996 or after, you've likely had two doses and then in the early 2000s, adults who had only received one dose became eligible for a second dose.

That's why people need to look at their vaccine history. If you haven't had clear documentation of two doses of the MMR vaccine or the MMRV vaccine, then we recommend that you do get those to make sure you have those two doses — especially if you're going to be travelling in the coming weeks and months outside of Canada, especially because this is a global phenomena and it's increasing rapidly.

It's due to falling vaccination rates because of the impacts of COVID-19, lack of access to care and also some of the anti-immunization sentiment in the last few years.

If you don't know if you've been immunized at all, then getting another dose of the MMR or MMRV vaccine — certainly a single dose if not two doses — there's no real risk from that.

Where can you get the vaccination?

If you have a primary care provider, they all have MMR or MMRV vaccine, the primary care pharmacy clinics, I believe there's 25 of those, they have that. If you don't have access to either of those, and lots of Nova Scotians don't, call your local public health unit and they'll find ways to help you if you have no other way to get immunized.

Have there been any measles cases in Nova Scotia?

Not this year. We had one a number of months ago last year. That was before the global resurgence. But we've had an increase in measles activity since the 1990s. What's happening now is a substantive sharp increase in an ongoing decades-long increase in measles activity.

It's really important that people get immunized because it's not just about themselves. If they get exposed, they get on a plane and they come back to Canada, all of a sudden we have large numbers of people potentially exposed.

Measles is so very infectious. Even if you go into a room a couple hours after somebody's been there with measles, you're still exposed to the virus. That is very contagious.

What is Nova Scotia doing to prepare for measles?

Last weekend, information went out to all primary care providers in the health system reminding them of the situation, what they need to be alert for to be looking for measles, if people appear clinically, what to do about it in terms of testing, but also who's eligible for vaccination.

I know both Nova Scotia Health and the IWK are doing similar work now with all their staff because it's really important that staff — because of their potential to be exposed in an emergency department — are up to date with their measles vaccination as well, because if they're exposed or not fully immunized, they have to be off work for a period of time and that has lots of workplace issues.