Even people born before 1970 are encouraged to get measles shot for international travel

New Brunswick Public Health is encouraging people born before 1970 to get a measles vaccine if they plan to travel outside the country.

The advice comes amid a surge of measles in Europe and a rise in cases across North America, related in part to a decline in routine vaccinations during the COVID-19 pandemic.

"Since publicly funded vaccine programs only began in the early 1970s, most adults born before 1970 are presumed to have acquired immunity from past exposure to the measles virus," said Department of Health spokesperson Sean Hatchard.

"However, if they plan to travel outside of Canada, they should consider receiving one dose of the MMR [measles, mumps and rubella] vaccine before their journey," if they have not previously received a measles vaccine, he said in an emailed statement.

"This is in line with the current National Advisory Committee on Immunization (NACI) advice on measles vaccines."

This dose is not currently publicly funded but is available through a number of travel clinics across the province. It costs about $140.

New Brunswickers born in 1970 or later who have not received two doses of a measles vaccine should contact their primary care provider or local Public Health office to be immunized, said Hatchard.

"Measles is highly contagious and being fully vaccinated provides almost 100 per cent protection," he said.

N.B. cases 'certainly possible'

Measles is transmitted through the air when an infected person breathes, coughs, sneezes or talks, or by direct contact with infected nasal or throat secretions.

The virus can cause serious illness and severe complications, including deafness, brain damage and even death.

"Given the current global and national measles situation, it is certainly possible for New Brunswick to see cases of measles here at home," said Hatchard.

Measles has been considered eliminated in Canada since 1998. Although cases do still occur, "ongoing and sustained transmission" does not, he said.

Most measles cases that have occurred have been acquired from travel outside Canada, with "very limited spread" within the country, said Hatchard.

"Therefore, the largest risk of measles exposure is with international travellers who may be visiting countries where measles is circulating."

"Since international travel increases the risk of exposure to measles, as a precaution, Public Health New Brunswick is recommending that these individuals consider getting at least one dose of the measles, mumps and rubella (MMR) vaccine before travel."

New Brunswick's last incidence of measles — an outbreak in Saint John in 2019 — started through international travel. A person who had recently travelled to Europe became the province's first case since 2017. The outbreak lasted more than two months, with a total of 12 cases confirmed.

"Our ability to limit the spread of measles rests largely on ensuring that our population has a high vaccine coverage. That is why it is important to address missed immunizations now as the best way to prevent measles," Hatchard said.

Vaccination rate below target

In New Brunswick, children are routinely immunized with two free doses of the measles, mumps, rubella and varicella (chicken pox), or MMRV, vaccine at 12 months and 18 months of age.

As of Dec. 31, about 85 per cent of seven-year-olds in the province have had at least two doses of the MMRV or MMR vaccines, said department spokesperson Katelin Dean. This data is for all seven-year-olds — not just those attending public schools, she said.

Dean did not respond to repeated requests for vaccination rates for older youth or adults. It's unclear if such data exists.

According to experts, at least 95 per cent of the population must have immunity to the virus — either through vaccination or prior infection — to prevent an outbreak.

As part of New Brunswick's routine immunization schedule, adults born in 1970 or later who have not previously received two doses of the measles, mumps and rubella (MMR) vaccine are eligible to receive two doses one month apart, or receive one dose if they have had one previous dose in childhood, said Hatchard.

"New Brunswickers are encouraged to consult with their health-care provider or a travel clinic before they travel to ensure they are up to date with their immunizations," said Hatchard.

Watch for post-March break measles

People who recently returned from March break travel should be watching for symptoms, Dr. Yves Léger, acting chief medical officer, has said.

It can take up to 21 days after exposure to the virus for symptoms to appear, according to the Public Health Agency of Canada, and people who are infected can spread the virus to others before they develop symptoms.

Research suggests that one person with measles can spread it to an average of 12 to 18 others.

Measles typically starts with cold-like symptoms, such as fever, cough, red, watery eyes, and runny nose.

About three to seven days after symptoms begin, a rash that looks like small red spots appears. It usually starts on the head/neck and spreads down the body, arms and legs.

Anyone who develops symptoms should get assessed by contacting Tele-Care 811 or eVisitNB, said Hatchard. He did not include primary care providers or after-hours clinics.

If people have "severe or concerning symptoms," they should visit the nearest emergency room, he said.

Public Health prepares

"New Brunswick remains vulnerable to diseases occurring globally or nationally — with international air travel allowing people to cross the globe in the span of a day, we recognize the importance of being well prepared for potential cases," said Hatchard.

"Although Public Health New Brunswick has experience in managing measles cases, we are taking steps to help prevent and better respond to any future measles cases in the province," he said, without elaborating.

The acting chief medical officer of health previously told CBC News that Public Health officials have been reviewing their guidelines for how they manage measles cases and contacts, and working with the communications branch to encourage New Brunswickers to ensure they're up to date with their vaccines, especially if they're travelling.

Public Health also planned to distribute a memo to health-care practitioners to raise their awareness, make sure they're keeping an eye out for any potential cases, and encouraging vaccines with their patients, Léger said.