Toronto metro area measles alert

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Source: http://www.oakvillebeaver.com/news/article/165271

Region issues measles alert
News
Apr 03, 2008

Halton's Health Department has issued a public alert after a man may have unknowingly spread measles in a variety of places in and around town while he was contagious late last month.
The man, in his 30s, has tested positive. The test was confirmed by the Provincial Public Health Laboratory on April 1.
That means the man was potentially infectious from March 21 through to March 30.
Measles is a highly contagious disease spread through coughing, sneezing, or talking and by direct contact with nasal or throat secretions.
A person with measles is contagious from three to five days before the rash appears, until approximately four days after.
Signs and symptoms of measles include fever; cough; runny nose; red, burning, teary eyes; white spots on the inner lining of the mouth; and a rash, which starts on day three to five of the illness and can last up to six days.
During his contagious period, the Oakville man, unaware of his measles visited the following places:
? Halton Healthcare Services (HHS), Oakville-Trafalgar Memorial Hospital (OTMH), Maternal Child Department between March 21 and March 26, and at the OTMH Breastfeeding Clinic between 9:30 a.m. and noon on March 29.
? Oak Park Medical Clinic, on Sixth Line, on the afternoon of March 27 and again on the evening of March 28.
Halton Region Health Department staff is contacting patients seen at the clinic and working with hospital officials to identify potential exposures that occurred at OTMH.
"It is important to note that newborns of immune mothers are very unlikely to become infected because of the transfer of protective antibodies from their mothers," said Dr. Tom Szakacs, Infectious Diseases Consultant at HHS.
The individual also visited:
? Toronto Raptors' Game in the Air Canada Centre, Toronto, March 23, section 320, row 15, seats 20 and 21.
? 2:30 pm GO train from Oakville GO Station to Union Station, Sunday, March 23. He was seated approximately in the middle of the train, second level, in the middle of the car.
? 6:43 pm GO Train from Union Station to Oakville GO Station, Sunday, March 23. He was seated approximately in the middle of the train, second level, in the middle of the car.
? First Choice Hair Cutters on 2423 Trafalgar Road in Oakville on Monday, March 24 during the late afternoon.
The risk for the general public is considered low because most people are immune to measles as a result of past illness and Canada's high immunization rates.
"Although measles is easily transmitted, individuals who have had one dose of the measles vaccine are 85 to 95 per cent likely to be immune and those who have had two doses of the vaccine are considered virtually 100 per cent likely to be immune," said Dr. Monir Taha, Associate Medical Officer of Health for Halton Region.
"Also, anyone born prior to 1970 is considered to be naturally immune to the disease," said Taha.
The risk of getting infected with measles in a public setting is very low so a person who visited these places at the times listed has only a very small chance of becoming ill with measles even if he or she has never had measles or has never been immunized against measles.

Should such a person develop illness as described above, they should seek the advice of a physician.
It is important to call ahead to make an appointment and to be sure to explain that you may have been exposed to measles.
That way your doctor can arrange to see you without exposing others. An assessment by a physician and blood tests are required to confirm the diagnosis.
For those without a family physician, call Telehealth Ontario at 1-866-797-0000.
For more information, call Halton Region Health Department, 905-825-6000 or visit www.halton.ca/health.
For questions concerning OTMH, call 905-845-2571, ext. 6788. If you live in the City of Toronto, call 416-338-7600.
- 30 -

 

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Re: Toronto metro area measles alert

Source: http://www.theglobeandmail.com/servlet/story/LAC.20080405.MEASLES05/TPStory/TPNational/Ontario/



MEASLES CARRIER MAY STILL BE AT LARGE
Outbreak worries health officials

JAMES BRADSHAW

April 5, 2008

Public health officials are concerned the original carrier of a recent outbreak of measles may still be at large after it was determined that none of four reportedly infected people has travelled recently, effectively ruling them out as the source.

Officials said measles continues to have potentially serious consequences, and a warning will be in effect for the Greater Toronto Area at least until the end of April should no new cases be reported. Despite obvious concern, the risk to the general public is described as low, thanks to extremely high immunization levels.

"When we know that measles was acquired in the city, that's what concerns us because that means that some people somewhere have the infection and are transmitting it to others unknowingly," said Vinita Dubey, associate medical officer of health for Toronto Public Health.

The first case was confirmed on April 1, when an Oakville man in his 30s was diagnosed. Three cases have since sprung up in Toronto in a 10-year-old girl, a 34-year-old woman and a 42-year-old man. A fourth is being investigated.

The woman was vaccinated once as a child; single vaccinations give only about 85-per-cent immunity. Doctors encourage two doses. The others had not been immunized.

"About one in a thousand people who get measles die from it, and about one in a thousand get the virus infecting the brain, leading to permanent brain damage," said Monir Taha, associate medical officer of health for the Halton Region Health Department.

Both he and Dr. Dubey said it is more common for patients to spend a week in bed sick.

Health officials said their worries are mitigated by the high immunity rate in North America. About 94 per cent of school-age children in Canada have had both vaccinations. Health Canada generally considers adults born before 1970 to be naturally immune.

Symptoms include cough, runny nose and fever, followed by a rash.

 

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Re: Toronto metro area measles alert

Source: http://www.thestar.com/News/GTA/article/411147

Health officials warn of possible measles outbreak
Anyone who visited certain sections of East General Hospital or the East End Community Health Centre on particular dates may have been exposed to the disease

Apr 07, 2008 07:44 PM
Brett Popplewell
Staff Reporter

Toronto Public Health is warning the public about a possible measles outbreak after five cases of the illness were reported in the GTA in the last few weeks - a number of cases equivalent to the annual average.

Health officials still aren't sure how the highly contagious disease came to Toronto but they have discovered that the disease was communicated between patients.

They are warning anyone who may have visited the East General Hospital's Emergency Room at night on April 1 and the hospital's Prenatal Assessment area during the night's of April 1 and April 2 as well as the hospital's floor A3 during April 5 or the East End Community Health Centre during the evening of April 2 that they might have been exposed to the disease.

Symptoms of measles include cough, runny nose, fever, white spots in the mouth and red, watery eyes that are sensitive to light. These symptoms are followed by a red rash that lasts about six days. Measles is caused by a virus and can have deadly consequences if babies or very young children are exposed to it.

Most people in the GTA are immune to the disease thanks to vaccinations, however anyone who may be experiencing the symptoms are asked to contact their physician immediately before going to hospital.

 

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Re: Toronto metro area measles alert

Source: http://www.citynews.ca/news/news_21577.aspx

Toronto Public Health Confirms 5th Case Of Measles In Four Weeks
Thursday April 10, 2008
CityNews.ca Staff

Alarming news from Toronto Public Health today: the city confirmed the 5th case of measles in four weeks.

And it happened at place frequented by children: The Ontario Science Centre.

If you were at the Don Mills and Eglinton location Wednesday, April 2 before 1:30pm, watch out for symptoms.

They include: cough, runny nose, fever, white spots in the mouth and red watery eyes that are sensitive to light. These symptoms are followed by a red rash which lasts about six days.

If that sounds like you, see a doctor. But call first and let the office or hospital know you may have been infected.

Measles aren't usually deadly, and most people recover without any treatment. Infants, pregnant women, and those with a weakened immune system are the exceptions and should check their vaccination records immediately.

"In the past few weeks, we've see more cases than the last year," notes CityNews Medical Specialist Dr Karl Kabasele.

That's what makes this outbreak so unusual: Toronto has on average three cases of measles a year. Here, it's only April and five people have been infected.

If you think you might add to that number, watch yourself for symptoms, check your medical records, and call a doctor.

Find out more about the disease here.

 

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Re: Toronto metro area measles alert

Source: http://www.insidetoronto.com/News/NorthYork/article/45626

Another measles case linked to Ontario Science Centre
BY LISA QUEEN
April 11, 2008 11:04 AM

Another case of the measles linked to the Ontario Science Centre has been confirmed by Toronto public health.

Of the five cases confirmed during the city's outbreak of the disease, four have been linked to the popular North York tourist attraction at 770 Don Mills Rd, just south of Eglinton Avenue.

Public health officials are asking anyone who was at the science centre on April 2 before 1:30 p.m. to watch out for symptoms, which include cough, runny nose, fever, white spots in the mouth and red and watery eyes that are sensitive to the light. These symptoms are followed by a red rash that lasts about six days.

If you begin exhibiting symptoms, public health advises you seek medical attention. But because measles is so contagious, make sure you call the medical facility before going to advise them you may have been exposed to the measles.

Most people who contract the disease are generally sick for about 10 days but recover completely without treatment.

A small percentage can develop complications such as pneumonia, swelling of the brain and spinal cord and, in extreme cases, death.

Measles is a highly contagious disease spread by droplets and direct contact with nasal and throat secretions of an infected patient. It can also be spread through the air. A person with the disease can infect others from four days before to four days after a rash develops.

"Measles is one of the most contagious diseases there is. Even going into a room where someone (with measles) has been an hour ago, you can get it," said Dr. Rita Shahin, Toronto's associate medical officer of health.

The latest case comes almost a month after three other patients contracted the disease at the science centre.

A 10-year-old child and two young adults developed measles after visiting the facility over the March Break.

The risk of infection among the general public is considered low because of Canada's high immunization rate and high immunity, public health said. The vaccination rate among school-aged children in Toronto is 98.6 per cent.

People born before 1970 likely had the measles as children and are therefore considered protected.

Those born after 1970 who were not vaccinated and have been exposed to the disease are considered most at risk.

Public health held clinics earlier this week to provide vaccinations for people who may have been exposed to Toronto's fifth measles case, a woman who visited Toronto East General Hospital on April 1, 2 and 5 and the East End Community Health Centre on April 2.

 

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Re: Toronto metro area measles alert

Source: http://news.guelphmercury.com/News/article/316072

96 kids kept at home
April 12, 2008
Rob O'Flanagan
Mercury Staff

GUELPH

Close to 100 students at John McCrae Public School will have to stay home from school until April 22 and live in isolation until the threat of a measles outbreak in Guelph passes.

"We are trying to prevent a widespread outbreak from occurring, which is why we are asking them to exclude themselves from school and other social situations," said Dr. Nicola Mercer, acting medical officer of health and CEO of Wellington-Dufferin-Guelph Public Health. "Obviously we are concerned that it could go to other schools.

"We are doing everything possible to prevent it going to other schools."

Ninety-six children are being instructed not to leave their homes over the next 10 days -- no malls, no birthday parties, no daycare.

"Children that the health unit doesn't have immunization records for are being excluded from school because they believe there is an outbreak or a risk of an outbreak at the school," said Maggie McFadzen, Upper Grand District School Board communications officer.

The children will be kept out of the school until public health determines the threat of the outbreak has passed. "They are not to leave their home and go any place where they might expose other people," Mercer said. "They need to be socially isolated with their families until the period of incubation is over."

Public Health officials determined that these children were not adequately immunized and were possibly in contact with two children at the school who came down with the disease.

Public health officials have also determined that the two known cases of measles at the school occurred in children from families who are "conscientious abstainers" from vaccination programs.

A third case of measles has also be confirmed, this one outside the school, but directly linked to the John McCrae cases.

It is believed the potential exposure to the red measles virus happened at the school on or about April 1. However, officials were only able to confirm the positive cases at the school Wednesday, April 9, and issued exclusion orders at that time. Therefore, for over a week children who were possibly infected with the virus were going freely about in the community. The incubation period for measles is 21 days.

The fact that children have not been fully immunized against the measles is not uncommon, Mercer said. Some parents do not believe in immunization, others are not up to date on their child's shots.

The MMR vaccine requires two shots. A previous course of vaccination required that the first take place just after 12 months of age, and the second prior to the age of six. The vaccination schedule changed in 2005, so that shots are now given at 12 and 18 months.

"It's just unfortunate that we have a whole population of kids between the ages of four to six who were waiting for their second needle, and some were delayed in getting that second needle," Mercer said. "Then here we are with a potential case of the measles. So I have to exclude them from the school."

McFadzen said John McCrae Public School is coping well. "They really appreciate that they have had a lot of assistance from the health unit," she said.

roflanagan@guelphmercury.com

 

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Re: Toronto metro area measles alert

Source: http://www.thestar.com/News/GTA/article/413835

Sixth case of measles makes it an outbreak

Apr 12, 2008 04:30 AM
Donovan Vincent
City Hall Bureau

When does a spate of measles infections become an outbreak?

Not often it seems.

But cluster the cases together, have them pop up within weeks of each other and you've got an outbreak on your hands.

That's what has happened in Toronto.

Yesterday, Toronto's health department announced a sixth confirmed case of the highly infectious disease in the past four weeks ? Halton also has one related case of its own. It's suspected that most of those cases were infected at the Ontario Science Centre.

"In Toronto we have an average of about three cases a year. Here we have six cases in a few weeks,'' Dr. Barbara Yaffe, Toronto's associate medical officer of health, said in an interview yesterday.

But Yaffe says the public shouldn't be alarmed, adding she would have "no hesitation'' going to the Science Centre. (A spokesperson there insisted yesterday that there's been no drop-off in visits as a result of the warning.)

Officials are warning anyone who was at the Science Centre April 2 before 1:30 p.m. to watch for symptoms that include a cough, runny nose, fever, white spots in the mouth and red watery eyes sensitive to light.

These symptoms are usually followed by a red rash that lasts about six days.

Most people are sick about 10 days and recover without treatment, but 10 per cent of all cases develop complications like ear infections, pneumonia, or diarrhea.

 

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Re: Toronto metro area measles alert

Source: http://www.citynews.ca/news/news_22512.aspx
More Cases Of Measles Reported In Toronto
Thursday May 8, 2008
CityNews.ca Staff

A measles outbreak has reared its ugly head in Toronto again, with four new cases reported to Public Health in the past few days. Initial reports of the illness surfaced in early spring. Nine cases have now been reported since the start of the investigation into the sudden breakout.

Outbreaks have also been noted in other parts of Ontario, as well as in Europe and the United States.

"All of the new cases either live or work downtown," reveals Dr. Barbara Yaffe, Director of Communicable Disease Control for Toronto Public Health. "Anyone born before 1970 likely had measles in childhood, and is therefore protected. Everyone else should ensure they have had two doses of measles vaccine for full protection, especially as we know measles is circulating in Toronto."

Measles is rare in Canada, and only about three cases are seen in Toronto each year.

Toronto Public Health is recommending that those who received a single vaccination as children, consider getting a second dose.

"Complete and up-to-date vaccination remains the best way to protect yourself and your family from communicable diseases like measles," Dr. Yaffe added. "Prior to universal immunization in the 1970s, Canada saw thousands of cases of measles each year."

 

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Re: Toronto metro area measles alert

Source: http://www.thepeterboroughexaminer.com/ArticleDisplay.aspx?e=1029324

Measles cases linked to science centre trip
Posted By FIONA ISAACSON
Posted 13 hours ago

One trip to the Ontario Science Centre in Toronto led to 10 cases of the measles at Chemong Public School in Bridgenorth, Peterborough County-City Health Unit reported last night.

Health protection manager Edwina Gracias said the first infection was initially misdiagnosed on March 26 and the health unit wasn't made aware of the outbreak until April 11 when two more cases were detected.

At that point the "illness was confined," although seven more people later developed symptoms, many of them siblings, Gracias said. One adult was infected, she said.

Gracias traced the investigation outlining how the health unit was able to determine there was a single initial infection.

It takes about seven to 21 days for symptoms to develop once infected, Gracias said.

It's also possible to have measles but not develop the symptoms, she added.

Sixty children had to stay away from the school until the infection period was over because they weren't immunized, Gracias said.

Children can be immunized by their family doctor or at the health unit, but some people choose not to for medical or personal reasons, she said.

Medical officer of health Dr. Garry Humphreys applauded the Provincial Health Laboratory for confirming it was measles within 24 hours through a blood sample and health unit staff for their quick action.

As of May 13, there have been 36 cases of measles affecting eight health units in Ontario, including Peterborough, since the start of the year, Gracias said.

fisaacson@peterboroughexaminer.com

 

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Re: Toronto metro area measles alert

Source: http://toronto.ctv.ca/servlet/an/lo..._Brampton_080519/20080519/?hub=TorontoNewHome

Students, staff in Brampton exposed to measles

Updated: Mon May. 19 2008 7:15:37 PM

ctvtoronto.ca

More than 100 Brampton students will stay home from school on Tuesday because they have been inadvertently exposed to the measles.

It was a long weekend indeed for officials at James Potter Public School who spent quite a bit of time contacting students and teachers who were exposed to the contagious infection.

School officials told 131 students and six teachers to stay home on Tuesday unless they can prove they've been immunized against the ailment.

The students and staff members came into contact with a visitor to the school on May 5 who showed symptoms of the infection soon afterwards.

That person is linked to someone who has a confirmed case of the measles, health officials said.

Health workers also said it is likely most of the students were vaccinated against the disease as a child and that as soon as they can provide proof from their doctors, they will be allowed to return to school.

The Greater Toronto Area has seen a larger outbreak of the measles this year than any other year. More than a dozen cases have been reported.

Symptoms of the measles include a red rash, as well as a fever, runny nose and burning eyes.

With a report from CTV Toronto's Roger Petersen

 

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Re: Toronto metro area measles alert

Source: http://www.insidetoronto.com/news/News/NorthYork/article/48525

Measles outbreak now linked to NYGH
BY LISA QUEEN
May 22, 2008 04:06 PM

A person contagious with measles, who may have accidentally exposed others to the disease at North York General Hospital, is the latest case in Toronto's ongoing outbreak of the illness.

Hospital officials are working with Toronto Public Health to contact people known to have come in contact with the infected individual.

But as a precaution, the health department is also asking the following people who visited certain areas of the hospital on May 13, 16 and 17 to call 416-338-7600 for an assessment: pregnant women, those with a weakened immune system, parents with children under the age of one, health care workers who aren't employees of the hospital and anyone who works with children.

The key times and departments are the yellow zone of the emergency department on May 13 from 7 a.m. to 10:30 p.m., the ultra sound room and waiting area on May 13 from 2 to 5 p.m., the main cafeteria on May 13 from noon to 3:30 p.m. and the emergency room and triage area on May 16 from 9:30 p.m. onwards and on May 15 at 5 p.m.

This marks the 15th case of measles since the outbreak began in March.

Measles is a highly contagious disease spread by droplets and direct contact with nasal and throat secretions of an infected patient. It can also be spread through the air.

A person with the disease can infect others from four days before to four days after a rash develops.

Symptoms include cough, runny nose, fever, white spots in the mouth and red, watery eyes that are sensitive to light. These symptoms are followed by a red rash, which lasts about six days.

The vast majority of measles patients recover fully, although a small percentage can develop complications such as pneumonia, swelling of the brain and spinal cord and, in extreme cases, death.

 

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Re: Toronto metro area measles alert

Source: http://www.theglobeandmail.com/servlet/story/LAC.20080523.MEASLES23/TPStory/TPNational/Ontario/

Measles plan not working, doctor warns
Tracking potential exposure may be 'futile:' better to vaccinate people at risk

UNNATI GANDHI

May 23, 2008
As public-health officials scramble to track down dozens of people possibly exposed to measles at a Toronto hospital late last week, one infectious-disease expert is wondering whether the situation has reached a point where the labour-intensive undertaking is "futile."

Fifteen cases of measles have been confirmed since the initial outbreak in March, and Toronto Public Health says it is investigating a number of others. Surrounding regions also have confirmed several cases, all linked back to Toronto.

By way of comparison, an average of 10 measles cases are reported in Canada each year, according to the Public Health Agency of Canada.

Many of the six most recently confirmed cases are believed to have originated in bank towers on Bay Street. Last week, a spokesman for Bank of Nova Scotia said the bank's trading floor was hit and "a handful of people" showed potential symptoms. Operations were not affected, Frank Switzer added.

But what is troubling public-health officials now is that a contagious individual inadvertently visited North York General Hospital's emergency room, ultrasound room and waiting area, as well as the cafeteria, on May 13, in effect putting dozens of people at risk, including children and those with weakened immune systems. The same person visited the hospital's emergency room and triage area again on May 16, according to Toronto Public Health. Several calls to the department's spokeswoman yesterday were not returned.

Neil Rau, an infectious-disease specialist at Halton Healthcare Services in Oakville, said that it can take as little as 30 minutes of being in the same room as a contagious individual to become infected. And while most people are either naturally immune to the virus or have become so through vaccination, the spread of the virus can effectively be exponential through those who aren't.

Symptoms often don't appear until four days after the person becomes contagious, and last four days after the characteristic red rash associated with the disease disappears.

And because those who might have been exposed - and who are not immune - need to be located within six days to administer proper treatments, public-health nurses may be getting nowhere fast in an outbreak of this size, Dr. Rau said.

"When you have less than 10 people total [exposed], over a short period of time, it works," he said. "But I'm starting to wonder: Are we getting to the point where chasing waves of exposures is going to become futile and are we better off aiming to make sure that those who need to be vaccinated are vaccinated?"

He said it may be time to set up vaccination clinics to get those most at risk caught up. That includes immigrants from countries where measles is still rampant and people born after 1970 who have not received their second booster shots.

 

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Re: Toronto metro area measles alert

Source: http://www.theglobeandmail.com/servlet/story/LAC.20080524.MEASLES24/TPStory/TPNational/Ontario/

HEALTH CARE
Criticism of measles strategy 'premature'

SUSAN KRASHINSKY

May 24, 2008

As outbreaks go, it could be much worse.

That's the message coming from Toronto Public Health as the search continues for people who may have been exposed to measles at North York General Hospital last week.

There have been 15 cases confirmed in the city since March, compared with a typical total of three a year. Concerns were renewed when a contagious person visited the hospital twice, putting others at risk.

An infectious disease specialist has criticized the approach of Toronto Public Health and suggested moving to a rush immunization program.

Neil Rau of Halton Healthcare Services said in an interview with The Globe and Mail that with measles, there is a very small window to find and treat non-vaccinated people who are at risk: "Are we getting to the point where chasing waves of exposures is going to become futile and are we better off aiming to make sure that those who need to be vaccinated are vaccinated?"

It's a fair argument, said Barbara Yaffe, director of communicable disease control with Toronto Public Health. But it may not be realistic. "I think that's premature," she said, partly because 58 per cent of Toronto's measles cases are people aged 19 to 39.

Unlike with a vaccine catch-up program such as the one conducted in Toronto schools in 1996, she said, adults are not a captive audience.

It's important to note, Dr. Yaffe said, that the cases have been mild ones "with no severe complications."

 

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Re: Toronto metro area measles alert

Source: http://www.insidetoronto.ca/News/NorthYork/article/48756

NORTH YORK: Measles outbreak may bring new strategy

Contagious woman visited NYGH
BY LISA QUEEN
May 27, 2008 03:02 PM

Toronto Public Health officials are assessing if they need to beef up efforts to control the spread of measles after North York General became the second hospital to find itself at the centre of the city's growing outbreak.

Last week, public health announced a woman contagious with red measles accidentally exposed patients and staff to the disease when she visited areas of the hospital on May 13, 16 and 17.

In April, health authorities announced a similar situation when a woman contagious with the illness accidentally exposed others when she visited Toronto East General Hospital and the East End Community Health Centre.

Dr. Vinita Dubey, Toronto's associate medical officer of health, doesn't blame the health facilities for failing to recognize the women had measles.

Before victims of the highly contagious disease develop the tell-tale rash of measles, they can exhibit general symptoms such as a runny nose, watery eyes and a fever for several days.

But with the number of cases during the outbreak now at 17 in Toronto and more than 30 across Ontario (as of Tuesday, May 27), Dubey said it may be time to introduce more aggressive measures to stop the spread of the disease.

"We're evaluating... what's the best way to make a difference," said Dubey, adding that public health has sent out warnings to hospitals to be on the look-out for potential measles cases.

"We're continuing our ongoing investigation."

New measures could include:

- Increasing efforts to publicize information about symptoms and vaccinations;

- Warning people who are ill against making unnecessary visits to health care facilities;

- In these post-SARS (Severe Acute Respiratory Syndrome) days, reminding people with coughs and fevers who do need to visit health facilities that they should call ahead or at least identify themselves upon arrival so medical staff can determine if they need to be isolated;

- Implementing different follow-up procedures of people exposed to measles;

- Encouraging people born between 1970 and 1995, who are more at risk due to immunization patterns during that time, to get properly vaccinated.

The vast majority of measles patients will recover fully, although a very small percentage can develop complications such as pneumonia, swelling of the brain and spinal cord and, in extreme cases, death.

Toronto has about three cases of measles in a typical year and those are usually travel-related.

But the current outbreak is a riddle because the original source had not travelled, Dubey said.

"In Toronto, it's a mystery. We know it started with an individual and spread," she said.

"We don't know where the individual got it."

Several cases have been traced to the Ontario Science Centre over March Break and the downtown financial district.

North York General's media relations manager Courtney Sorger referred questions about last week's case at the hospital to the public health department.

 

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Re: Toronto metro area measles alert

Source: http://www.thestar.com/article/437217

Outbreak threat from vaccine dodgers
At some Toronto schools, not enough children are vaccinated to prevent the spread of diseases like measles
Jun 04, 2008 10:29 PM
Brandie Weikle
EDITOR, PARENTCENTRAL.CA

As few as one third of students at some Toronto schools have had mandatory vaccinations, leaving most vulnerable to outbreaks of highly contagious diseases like measles, health officials warn.

While the overall vaccination rate for Toronto schools tops 98 per cent, there are individual schools where the rate is far too low, said Dr. Vinita Dubey, an associate medical officer of health for Toronto Public Health.

?For something like the measles, you need coverage in the high 90s because it is so contagious and no vaccine is 100 per cent,? Dubey said. For vaccine-preventable diseases in general, at least 90 per cent of students should have all shots up-to-date for their age, she said.

However, documents obtained by thestar.com show that 110 Toronto schools have vaccination rates of 85 per cent or less.

At the school with the poorest level of compliance, Greenwood Secondary School near Greenwood Ave. and Danforth Ave., just 31.7 per cent of students had up-to-date vaccinations. The school with the second-lowest rate of compliance, Alpha Alternative School (Junior) near Adelaide St. W. and Spadina Ave. in Toronto, had just 34.2 per cent fully vaccinated.

There are currently 21 confirmed cases of measles in Toronto ? which typically sees just three per year ? and more than 40 in Ontario. This is the worst outbreak since 1996, the year a second ?booster? shot of the measles-mumps-rubella vaccine was introduced.

The World Health Organization estimates that measles killed about 242,000 people in 2006. One to two out of a thousand cases in children lead to death.

Measles is one of the most contagious illnesses known, and it can quickly spread in a school setting. Unvaccinated students and staffers at two schools ? Three Valleys Public School near York Mills Rd. and Don Mills Rd., and the exclusive private school Branksome Hall in Rosedale ? were ordered home by health officials when someone associated with the school contracted measles.

Symptoms may include cough, runny nose, red and watery eyes that are sensitive to light and a low-grade fever, followed by a rash. The illness lasts one to two weeks, with most people recovering within 10 days.

Dubey said the case that started the current outbreak has been tracked to an adult male who visited the Ontario Science Centre in mid-March and spread the airborne virus to three other people.

Public health officials do not know how the disease spread from there, though they made efforts to trace the paths of infected individuals and warn those who may have come into contact with the virus that they should watch for symptoms.

?We are not sure how he contracted the infection. Usually these cases are related to travel,? says Dubey. ?Now what we?re seeing is that you could be living and working in Toronto and get exposed to measles here.?

So far, the current measles outbreak in Toronto has not spread in schools. That?s because enough students are vaccinated to provide individual protection for most and to achieve ?herd immunity? for the few who are not. It?s also because at schools where a student has fallen ill, Toronto Public Health has exercised its right to send home students who were not vaccinated.

Health officials have taken the same approach in Peel Region, Peterborough and in Guelph, where an adult who contracted measles at the Science Centre volunteered at a school during the contagious stage prior to the telltale red rash.

The children who contracted measles were unvaccinated, either because their parents had opted to forego immunization, or because they were under the age of one and not yet old enough to have started the MMR series. Had a group of students from one of the schools with inadequate MMR coverage been visiting the Science Centre that day, says Dubey, the outcome could have been much worse.

In 2005, there was a rubella outbreak at a Norwich, Ont. religious school where many students were not vaccinated. More than 220 people contracted the disease, including a number of pregnant women whose unborn children were put at risk of birth defects. The outbreak of the disease?also known as German measles?was believed to have originated with a Dutch visitor during a time when the Netherlands had been battling rubella for eight months .

Why aren?t they vaccinated?

Ontario?s Immunization of School Pupils Act allows public health officials to suspend students whose vaccines aren?t up to date, but parents can apply for an exemption on one of three grounds: a medical condition, prior immunity (such as immunization in another country for which the family has no records), and religious/?conscientious? reasons.

?Some parents I know don?t do it because of the stuff the vaccines are mixed with,? says Fiona Foderingham, mother of Ikeia, 7, a student at Kimberly Jr. School, and Isaac, 2. ?They?re worried about allergic reactions.?

Parents who spoke to parentcentral.ca cited allergic reactions, along with mercury levels, testing on embryos, the development of ?natural immunity,? autism and side effects as reasons some opt not to have their kids immunized.

?Parents are well aware now that vaccines contain toxic substances such as aluminum, which is a neurotoxin, and they simply do not want to inject this into their infants,? says Edda West, a spokesperson for the Vaccine Risk Awareness Network, a national organization based in B.C.

?As more and more people worry about the impact of environmental toxins on our lives, they are simply unwilling to inject toxic substances into their young children,? West added, ?and no amount of denial by the medical profession is going to change this.?

Dr. Vinita Dubey, an associate medical officer of health for Toronto Public Health, says a great deal of research goes into ensuring vaccines are safe, and that getting vaccinated ?doesn?t overload the immune system, which is what some parents believe.? She said the antigens in a vaccine are miniscule compared to those commonly encountered in subway cars and sandboxes.

She also warned that parents may have become complacent about contagious diseases because they haven?t seen them. ?When you?ve grown up never seeing a disease, you come to think that illnesses like measles are not around,? Dubey said.

?There?s no question that without a strong immunization program, those diseases will come back.?

In Toronto, 25 schools have exemption rates between six and 62 per cent. At Alpha Alternative, exemptions have been granted for 47 out of 76 students. Principals at Alpha Alternative and 15 other schools with low vaccination compliance declined to comment.

Eight schools share a building with an alternative school where the student body has a significantly higher percentage of students exempted from immunizations.
-With files from Carmen Chai