Worried about measles over March Break? Here's what Windsor's top doctor says

It's March Break, and plenty of families will be hitting the road or boarding  a plane for a vacation. But health officials, including in Toronto, are warning parents about the highly-infectious virus ahead of the travel week. 

Measles was once eradicated in Canada. But with COVID-19 shifting public health priorities for years, many health agencies, and parents, fell behind on getting kids their routine immunizations, said Dr. Mehdi Aloosh, the medical officer of health for the Windsor-Essex County Health Unit.

With some hesitant to get their vaccinations, public health units are gearing up for measles outbreaks. 

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Windsor's health unit warned in January about possible exposure in the community linked to international travel. While that case didn't spin off into any others in the community, Aloosh says next time Windsor-Essex might not be as lucky. 

He urges families to think about a measles vaccine ahead of their March Break travel — and there's still time, he says.  

Aloosh spoke with CBC Windsor News at 6 host Meg Roberts about the top things to know about measles ahead of March Break. 

This Q&A has been edited for length and clarity. 

What makes measles so dangerous?

Measles is not just an infection that has fever and rash. It sends children to a hospital. It can cause chronic neurological damage like deafness [and] blindness. Twenty per cent of children who get measles can go to a hospital as a result of pneumonia and other complications. 

The worst case scenario, children can die from this disease and the rate is one to three in 1,000 kids. So that's a significant danger, for me.

Measles was declared eradicated in Canada in 1998. Why are we seeing this outbreak in cases?

Yeah it's actually a very interesting story because we eliminated the disease from Canada, which means that we hadn't had a case inside. Most of them were coming from outside of Canada and two years after us, the United States was able to eliminate the disease. But now as a result of COVID and lack of access elsewhere … kids haven't received the vaccination that they needed, so they are susceptible. 

If we are not completely vaccinated we can contract the disease [outside Canada] and bring it back into Canada and spread among our community.

Our healthcare system here in Canada and elsewhere was very busy with COVID. So there were some missed opportunities there for kids to be vaccinated. 

Obviously we saw some vaccination hesitancy with the COVID-19 vaccine. Do you think that idea in people has led to lack of confidence in other vaccines?

I think that misinformation, disinformation has a very, very significant effect on hesitancy. Also trust in public health and all of the things that we do has eroded. 

What's the situation like here in Windsor in terms of the vaccination rates for measles?

We have data from last year because each year we review all of the vaccine records for elementary students and high school students. 

The level of vaccination is 90 per cent — it's better than some other health units.

It's not perfect because we need 95 per cent vaccination to prevent outbreaks in our schools [and] in our community, so there's huge capacity there to improve rates and we are in the middle of that work for this year. 

You know, the fact that you said that we could do a little bit better — it sounds like about five per cent better in terms of that vaccination rate — as we're having measles outbreaks across the country. Does that five per cent make you nervous?

As a physician I'm concerned about that that five per cent provides opportunity for the disease to create outbreak.

But even 95 per cent makes me concerned because what about those five per cent of kids who are unvaccinated, they can suffer from complications, pneumonia, end up in in a hospital, neurological damage. I think that's concerning.

This is a very safe vaccine, very effective vaccine. So I think [there's] a lot of room to go.

What's your message for people who are traveling during March Break?

I wish great travel for them. Educate yourself about the risk where you go and take your vaccines like you bring your sunscreen, you bring your mosquito repellents, you bring your protective clothing. Just talk to your healthcare provider. 

So of course you're thinking about your kids, but perhaps there are adults who are also thinking about themselves. Is there any advice for adults surrounding the measles?

Absolutely. This is an opportunity to check your vaccination, if you need an additional dose of vaccine, get it and then safely travel to your destination.

You need two doses of this to be immune. The first dose provide immunity, the second dose provides the lifelong immunity.

If you're born before 1970, in that time there wasn't vaccine and measles is very infectious, the most infectious disease we know. So the concept is that you got that disease and you are immune. 

In certain circumstances you may need additional dose. In that [case] you need to go to your healthcare provider [and] check the situation. 

It's an individual risk assessment. You need to go to your family doctor to check if you need, if you're born before 1970. If after that, then there's a room for you to get another vaccine, in consultation with a healthcare provider.

Can you get measles if you've already been vaccinated?

There's a chance, because I told you 97 per cent. So if you are vaccinated, there's a three per cent chance that you might get measles, but your disease will be much less severe than the person who is unvaccinated. And if you are unvaccinated, most likely you get the disease when you are exposed to someone.

There are a number of public health organizations that have issued warnings about measles. Why hasn't Windsor-Essex done that prior to March Break?

So our team has been very active in communication with our partner [at] schools, day cares and educational institutions, colleges [and] universities. We have been in touch with our health care partners. We provided tools and we provided support in preparation. 

It sounds like you are on alert for this. You are preparing potentially for a case of this in our community, another case.

Yes, cases and outbreak, because if you have a case in a school you expect that there will be an outbreak. We are more concerned about children, but for our general community the risk level is low if you're vaccinated. 

We have lots of tools to counter this situation. We have a very good vaccine. My level of concern is not that high. My concern is about that age group of children who are at more risk for hospitalization [and] all of those consequences that I mentioned.