Text Equivalent

Figure 1: Reported number of cases and incidence rates of measles in Canada, 1924 to 2011

Year Number of Reported Cases Incidence rate (per 1 million population)
1924 39216 4289.18
1925 22777 2450.72
1926 39429 4171.94
1927 28150 2921.03
1928 27733 2819.83
1929 42132 4201.02
1930 21606 2116.58
1931 25664 2473.16
1932 53508 5091.15
1933 13471 1266.90
1934 29115 2710.64
1935 83127 7665.01
1936 55724 5088.95
1937 57408 5197.65
1938 26328 2360.83
1939 44476 3947.46
1940 45851 4028.73
1941 81051 7043.63
1942 26258 2253.13
1943 60485 5128.02
1944 55317 4630.59
1945 26978 2234.76
1946 67528 5493.65
1947 39455 3143.57
1948 66004 5147.31
1949 58511 4351.23
1950 55653 4058.71
1951 61370 4380.76
1952 56178 3885.33
1953 57871 3898.35
1954 36850 2410.54
1955 56922 3626.07
1956 53986 3357.13
1957 49712 2992.90
1958 35531 2080.27
1959 N/A N/A
1960 N/A N/A
1961 N/A N/A
1962 N/A N/A
1963 N/A N/A
1964 N/A N/A
1965 N/A N/A
1966 N/A N/A
1967 N/A N/A
1968 N/A N/A
1969 11720 558.07
1970 25137 1180.31
1971 7454 339.40
1972 3136 141.14
1973 10911 485.11
1974 11985 525.47
1975 13143 567.90
1976 9158 390.54
1977 8832 372.25
1978 5858 244.46
1979 22444 927.38
1980 13864 565.52
1981 2307 92.95
1982 1064 42.36
1983 934 36.82
1984 4078 159.25
1985 2816 108.97
1986 14941 572.45
1987 2385 90.18
1988 611 22.81
1989 11145 408.59
1990 1033 37.30
1991 6178 220.35
1992 2903 102.32
1993 187 6.52
1994 514 17.72
1995 2359 80.51
1996 327 11.04
1997 531 17.76
1998 12 0.40
1999 29 0.95
2000 190 6.19
2001 27 0.87
2002 7 0.22
2003 16 0.51
2004 8 0.25
2005 6 0.19
2006 13 0.40
2007 102 3.10
2008 62 1.86
2009 14 0.41
2010 99 2.90
2011 701 30.83

Return to Figure 1

Figure 2: Reported number of cases and incidence rates of measles in Canada, 1998 to 2011

Year Number of Reported Cases Incidence rate (per 1 million population)
1998 12 0.00
1999 0.00 0.00
2000 190 6.19
2001 27 0.87
2002 7 0.22
2003 16 0.51
2004 8 0.25
2005 6 0.19
2006 13 0.40
2007 102 3.10
2008 62 1.86
2009 14 0.42
2010 99 2.90
2011 748 24.44

Return to Figure 2

Figure 3 : Distribution of confirmed measles cases, by epidemiological week and province, Canada, 2011

Week of Rash Onset Number of confirmed measles cases
Epi Week Number Start date of
Epi Week		 Alberta British Columbia New Brunswick Ontario Québec Saskatchewan Total
1 08-Jan-11 0 0 0 0 1 0 1
2 15-Jan-11 0 0 0 0 1 0 1
3 22-Jan-11 N/A N/A N/A N/A N/A N/A N/A
4 29-Jan-11 N/A N/A N/A N/A N/A N/A N/A
5 05-Feb-11 0 3 0 0 2 0 5
6 12-Feb-11 0 1 0 0 0 0 1
7 19-Feb-11 0 1 0 1 0 0 2
8 26-Feb-11 0 4 0 0 1 0 5
9 05-Mar-11 0 1 0 0 1 0 2
10 12-Mar-11 N/A N/A N/A N/A N/A N/A N/A
11 19-Mar-11 0 0 0 0 2 0 2
12 26-Mar-11 N/A N/A N/A N/A N/A N/A N/A
13 02-Apr-11 0 0 0 1 4 1 6
14 09-Apr-11 0 0 0 0 6 0 6
15 16-Apr-11 0 0 0 0 6 1 7
16 23-Apr-11 0 0 0 0 17 0 17
17 30-Apr-11 0 0 0 0 8 0 8
18 07-May-11 0 0 0 1 67 0 68
19 14-May-11 0 0 0 1 40 0 41
20 21-May-11 0 0 0 3 78 0 81
21 28-May-11 0 0 1 64 0 65
22 04-Jun-11 0 0 0 0 69 0 69
23 11-Jun-11 0 0 0 0 37 0 37
24 18-Jun-11 0 0 0 0 75 0 75
25 25-Jun-11 0 0 0 0 50 0 50
26 02-Jul-11 0 0 0 0 59 0 59
27 09-Jul-11 0 0 0 0 44 0 44
28 16-Jul-11 0 0 1 0 24 0 25
29 23-Jul-11 0 0 0 0 13 0 13
30 30-Jul-11 0 0 0 0 12 0 12
31 06-Aug-11 0 0 0 0 1 0 1
32 13-Aug-11 0 0 0 0 7 0 7
33 20-Aug-11 1 0 0 0 1 0 2
34 27-Aug-11 0 0 0 0 4 0 4
35 03-Sep-11 0 0 0 0 8 0 8
36 10-Sep-11 0 0 0 0 3 0 3
37 17-Sep-11 0 0 0 0 4 0 4
38 24-Sep-11 0 0 0 0 6 1 7
39 01-Oct-11 0 0 0 0 1 1 2
40 08-Oct-11 0 0 0 0 3 0 3
41 15-Oct-11 N/A N/A N/A N/A N/A N/A N/A
42 22-Oct-11 0 0 0 0 0 1 1
43 29-Oct-11 0 0 0 0 0 1 1
44 05-Nov-11 N/A N/A N/A N/A N/A N/A N/A
45 12-Nov-11 1 0 0 0 0 0 1
46 19-Nov-11 N/A N/A N/A N/A N/A N/A N/A
47 26-Nov-11 0 0 0 0 1 0 1
48 03-Dec-11 N/A N/A N/A N/A N/A N/A N/A
49 10-Dec-11 N/A N/A N/A N/A N/A N/A N/A
50 17-Dec-11 N/A N/A N/A N/A N/A N/A N/A
51 24-Dec-11 0 0 0 0 1 0 1
52 31-Dec-11 N/A N/A N/A N/A N/A N/A N/A
TOTAL 2 10 1 8 721 6 748

Return to Figure 3

Appendix E: Sample Measles Case Investigation Form

Calculation of Incubation and Communicability Period

This image is a timeline, describing how to determine the incubation and communicability period, using the dates of fever and rash onset:

Return to Appendix E

Appendix G: Algorithms for Health Care Settings

Algorithm A: Assessing healthcare workers’ susceptibility to measles:

This is a flow chart describing how to assess a healthcare worker’s susceptibility to measles. For new healthcare workers (HCWs), immune status and vaccination history should be assessed prior to employment.

Health care workers can be considered immune if they can provide documented evidence of prior infection with measles, or receipt of two doses of measles-containing vaccine. Evidence of one dose of measles containing vaccine requires that an additional dose be administered. For those who cannot provide evidence of prior vaccination, serological specimens should be collected, and one dose of measles-containing vaccine given. If serology indicates measles IgG negative or indeterminant, an additional dose should be given 28 days after the first. If IgG positive, they can be considered immune.

Return to Appendix G - Algorythm A

Appendix G: Algorithms for Health Care Settings

Algorithm B: Management of healthcare workers who are close contacts of a case of measles

This is a flow chart describing how to manage healthcare workers who are a close contact of a measles case. For healthcare workers (HCWs) who are close contacts of a case of measles, immune status and vaccination history should be assessed.

Health care workers can be considered immune if they can provide documented evidence of prior infection with measles, or receipt of two doses of measles-containing vaccine. No further vaccine is required, and they may return to work. Evidence of one dose of measles-containing vaccine requires that an additional dose be administered. Following this, they may now be considered immune, and can return to work.

For those who cannot provide evidence of prior vaccination with measles-containing vaccine, exclusion from work should occur if the period of communicability has begun. Serological specimens should be collected, and one dose of measles-containing vaccine given. If serology indicates measles IgG negative or indeterminant, an additional dose should be given 28 days after the first. Contacts should be excluded from work from the 5th to 21st day after the exposure. If IgG positive, they can be considered immune. No further vaccine is required, and they may return to work.

Return to Appendix G - Algorythm B

Appendix G: Algorithms for Health Care Settings

Algorithm C: Management of patients who are close contacts of a case of measles.

This is a flow chart describing how to manage patients who are a close contact of a measles case. For inpatients who are close contacts of a case of measles, immune status and vaccination history should be assessed.

Inpatients who were born before 1970, can provide documented evidence of laboratory-confirmed infection with measles, or can provide documented evidence of two doses of measles containing vaccine can be considered immune. No further vaccine is required, and they may return to work. Evidence of one dose of measles-containing vaccine requires that an additional dose be administered. Following this, they may now be considered immune, and can return to work.

For inpatients who cannot provide evidence of prior vaccination with measles-containing vaccine, isolation in an airborne infection isolation room should occur if the period of communicability has begun. Serological specimens should be collected, and one dose of measles-containing vaccine given. If serology indicates measles IgG negative or indeterminant, they should be considered non-immune. They should receive an additional dose of measles-containing vaccine given 28 days after the first. Contacts should be excluded from work from the 5th to 21st day after the exposure. If IgG positive, they can be considered immune. No further vaccine is required, and they may return to work.

Return to Appendix G - Algorythm C

Appendix I: Stakeholder Map

This is a stakeholder map describing the groups involved in the prevention and control of measles. The 4 stakeholder groups involved in the prevention and control of measles are: decision makers, transactors, active interests and audiences.

There are three concentric circles that look like a bull’s eye. In the center is the prevention and control of measles.

The innermost circle is the Decision makers group, which include departments, branches and/ or other jurisdictions that have a primary or shared role in regulating the risk.

Going outward, the next group is the transactors. Transactors are the stakeholders who are most affected by the risk issue and its management and have some sort of transaction related to the risk.

The Active Interests group is the most outward circle. These are individuals or groups who have a stake in the issue but are not directly impacted.

Outside of the circles are audiences, which include general media, other government departments and interested agencies and associations who are not actively engaged in the issue or its management.

Return to Appendix I