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Wednesday 19 March 2014

The Moose is Loose Again – Measles fever

BC is grappling with an outbreak of measles amongst a community which chooses not to immunize because of secular interpretations.  The community is wellknown in public health circles, and has been steadfastly adherent to those beliefs through multiple outbreaks of vaccine preventable diseases.  For the most part, the relatively insular community has limited transmission to neighbouring communities and their cooperation with public health professionals is an unwritten story of successful application of basic communicable disease control.  

Perhaps that is changing as this outbreak seems to be contracting more attention and in typical measles fashion – it is spreading.  Over 100 BC cases to date have been identifying with recent cases outside of the index community. Note that disease numbers will augment quickly and are only provided for the date of posting and should not be relied upon. Not to be ignored, there are similar importations noted in a related religious community in Alberta, and cases are being reported in PEI.  Sporadic cases in Ontario and Manitoba are also noted with no intent of being all-inclusive.

Concurrently Los Angeles County has reported a cluster of some 32 cases – several of which are linked to the Phillippines where thousands of cases have occurred and dozens of deaths since late 2013.   The country is currently engaging in a vaccination blitz trying to reach over 2 Million residents.

Exportation from the Phillippines has led to cases in Taiwan, other SE Asia countries and the UK.
While there doesn’t appear to be a clear link to the Phillippines, the outbreak occurred in the wake of typhoon Haiyan in November 2013.   Recall massive international aid efforts were mobilized, and the Phillippines became the centre of international relief, with innumberable aid missions, many originating within religious communities. One of which likely donated the unwanted scourge of the measles virus from a well-intentioned aid worker. 

A measles outbreak started in May 2013 in a related religious community in the Netherlands where over a thousand cases occurred and nearly a hundred hospitalizations by August Eurosurveillance report.  Careful detective work would likely uncover a link between between outbreaks, and given advances in genetic epidemiology, it will only be a matter of time before clarity on how at least four continents are now juggling with significant increases in measles activity.

See the previous posting on measles in Canada and why this is not a real surprise Moose is loose

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