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Measles and Rubella Weekly Monitoring Report

Week 07, 2015: February 15 to February 21, 2015

Key Points

  • In Canada, 18 new cases of measles were reported during week 07, by Ontario (n=6) and by Quebec (n=12).
  • Three provinces have reported recent measles activity; these events are not linked as the genotypes are different (D4 in Ontario, B3 in Quebec, D8 in Manitoba).
  • A total of 45 cases of measles, and 0 cases of rubella have been reported in Canada for 2015.

Epidemiological Summary

Figure 1: Number of cases measles (n=45) and rubella (n=0), by week of rash onset, as reported to the Canadian Measles/ Rubella Surveillance System (CMRSS) and Measles and Rubella Surveillance system (MARS), for the period ending February 21, 2015.

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During epidemiological week 07, 2015, 18 measles cases were reported, by Ontario (n=6) and Quebec (n=12). Rash onset for these cases occurred during week 06 (n= 5) and week 07 (n= 13).

The year-to-date total is 45 cases of measles and 0 cases of rubella for 2015.

Note that when additional cases are reported in advance of the cycle, these cases will be described in the appropriate reporting cycle.

Geographic Distribution

Figure 2: Distribution of confirmed measles and rubella cases by health region. Cases are included if they are considered activeFigure 2 - Footnote *.

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Figure 2 - Footnote *
Active cases or outbreaks are those in which the onset date of the most recent case/outbreak-associated case falls within 32 days of the issue date of this reportFootnote 1.

Laboratory Summary

Measles

To date in 2015, 23 measles cases have been genotyped and the genotypes were: D4 (n=16), B3 (n=6) and D8 (n=1).

Of the 19 reported measles cases in Ontario, 16 cases have been genotyped. All have an identical genotype D4 strain, based on the standard N-450 sequence.

From Quebec, 6 cases were genotyped and were genotype B3, identical to the MVi/Harare.ZWE/38.09 sequence variant (GenBank accession number JF973033), and identical to the virus reported in a multi-state outbreak in the United States.

Finally, 1 case from Manitoba, with travel history to India, was genotype D8 which is endemic in IndiaFootnote 2.

Figure 3: Distribution of measles genotypes detected in 2015 (n=23) by week of rash onset (if available, n=21) or specimen collection (n=2). Epidemiological weeks are assigned in accordance with WHO guidelines (WHO.WER.2012;9(87):73) with week 1 beginning on the first Monday of the year.

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Figure 3 - Footnote *
Genotype B3 sequences identical to sequence variant MVi/Harare.ZWE/38.09 (GenBank accession number JF973033)

The current global distribution of measles genotypes can be found on the WHO Measles Nucleotide Surveillance (MeaNS) websiteExternal Link.

For information regarding the interpretation and use of measles genotyping (including a discussion of genotypes and sequence variants), refer to Hiebert J and Severini A. Canada Communicable Disease Report. 2014; 40-12: 257- 260.

Footnote 1
Public Health Agency of Canada. Guidelines for the prevention and control of measles outbreaks in Canada. Canadian Communicable Disease Report. 2013. Vol. 39: Definitions: conclusion of an outbreak (p. 5).
Footnote 2
Rota PA, K Brown, A Mankertz, S Santibanez et al. Global distribution of measles genotypes and measles molecular epidemiology. 2011:204(Suppl 1);S514-S523.