Don’t allow measles back
Four cases of measles in Toronto, a city of 2.8 million people, may not seem much to worry about but two things make this particularly distressing.
First, public health officials can’t trace a link among the four. They aren’t from the same family, there’s no source case and none recently travelled outside Canada.
Yet these individuals must have contracted the measles virus from someone. And that means there are almost certainly more people with the disease circulating in Canada’s largest city.
The second troubling aspect is that measles is highly contagious and potentially deadly. It mustn’t be brushed aside as something not worth vaccinating against.
Quite the contrary. Children hit by measles face very real danger. Most typically endure a blotchy rash, puffy eyes, a sore throat, fever and then go on to recover. But some suffer serious complications including pneumonia, ear infections that can result in hearing loss, and an inflammation of the brain causing permanent damage and even death.
The good news is that this scourge is highly preventable through immunization. Indeed, measles was once considered virtually eliminated in this country. But it has roared back in recent years as significant elements of the population choose to skip vaccination on religious grounds, a mistaken belief that immunization is harmful, or through simple complacency and neglect.
It’s telling that three of the four laboratoryconfirmed cases of measles now being investigated by Toronto Public Health officials involve individuals who had not been vaccinated against the virus. And in the fourth case the patient received only one dose of vaccine instead of the requisite double dose.
The overall immunization rate against measles in Toronto remains fairly high, with well over 90 per cent of the population protected. One reason is Ontario’s requirement of an up-to-date immunization record in order for children to attend school. Unfortunately, parents can easily bypass that prerequisite by signing a Statement of Conscience or Religious Belief exemption form.
As a result, there are distressing gaps in immunization coverage in Toronto’s education system. Some centres, such as Alpha Alternative Junior School, have exemption rates approaching 40 per cent.
Asimilar hole in society’s armour against measles was responsible for hundreds of cases in British Columbia last year. It was centred on a fundamentalist Christian school. And gaps in coverage are helping to fuel a measles outbreak in the United States that has so far infected more than 100 people, with most cases linked to Disneyland in California.
No wonder public health officials here, and south of the border, are redoubling their call to have children immunized against the virus. Each unvaccinated person puts others at potential risk.
One possible response would be for Ontario to tighten provisions allowing parents to opt out of immunization and still have their children attend school. The exemption system could be made more rigorous, perhaps by requiring proof of religious affiliation.
Before going that far, however, the province should carefully monitor the response to public health agency efforts at boosting vaccination. If enough parents can be convinced to protect their children willingly, there should be no need for tougher measures.
New outbreaks of measles in Toronto and the U.S. underline the importance of vaccination