Guidelines for the Prevention and Control of Measles Outbreaks in Canada

Executive Summary

Measles in Canada: Canada has been free of endemic measles since 1998. However, cases due to importation will continue to occur as long as individuals travel between Canada and countries with disease activity. Maintaining elimination status will require enhanced surveillance activities, identifying and improving immunization coverage in susceptible populations, and providing education, both to the public and to heal professionals, on the importance of immunization.

Guidelines History: In 1991, the Advisory Committee on Epidemiology (ACE) issued the "Guidelines for Measles Control in Canada". These guidelines presented a concerted approach to control, based on high levels of immunization, national surveillance with a standard case definition and focused action on outbreaks. However, this approach was critiqued as resource intensive with questionable success. Subsequently, as recommended by ACE, a Consensus Conference on Measles occurred in late 1992, with proceedings published in early 1993. In 1995, ACE published the "Guidelines for Control of Measles Outbreaks in Canada", a revision based on recommendations from the Consensus Conference.

Updated Guidelines: In support of the PAHO campaign to eliminate measles and rubella in the Americas, and in response to the prolonged outbreak of measles in Quebec in 2011, the 1995 Guidelines for Control of Measles Outbreaks in Canada have been updated.

The revision of the Guidelines was undertaken by the Measles and Rubella Elimination Working Group (MREWG), facilitated and supported by PHAC. The MREWG working group is composed of a range of subject matter experts, with affiliations at the local, provincial, territorial and federal level.

The updated Guidelines have been prepared to assist Canadian public health authorities in their investigation and management of measles outbreaks, in order to: (i) prevent complications as a result of measles infection and (ii) limit secondary spread of measles during an outbreak. Key changes and updates in the Guidelines for the Prevention and Control of Measles Outbreaks in Canada (2012) include:

  • Updated immunization information to reflect current National Advisory Committee on Immunization recommendations;
  • Changes to susceptibility criteria for health care workers based on the updated Canadian Immunization Guide (CIG) (available online);
  • Recommendation for jurisdictions to publish an outbreak summary within one year of the conclusion of an outbreak;
  • Laboratory recommendations for clinical diagnosis and serology; and
  • Assessment tools (algorithms) for healthcare settings.

To obtain a copy of the full report, including figures and reference tables, send your request to:

Vaccine Preventable Diseases
Surveillance and Outbreak Response Division
Centre for Immunization and Respiratory Infectious Diseases
Public Health Agency of Canada

vpd@phac-aspc.gc.ca

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