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Alberta has now confirmed more measles cases than the entire United States has reported this year.
The province has been battling outbreaks since March and as of noon Monday, total case counts in the province had ballooned to 1,314.
The latest update from the U.S. Centers for Disease Control and Prevention shows that country has amassed 1,288 cases this year.
“Looking at the numbers it saddens me,” said Dr. Sam Wong, the president of the section of pediatrics with the Alberta Medical Association.
“I think if we had gotten to it sooner — and taken it more seriously sooner — then maybe we would not have reached this milestone where one province actually exceeds the entire case count for the United States, which has got 10 times the population as Canada.”
Thirty new cases were reported between midday Friday and noon Monday.
“It’s absolutely terrible,” said Dr. Lynora Saxinger, an infectious diseases specialist with the University of Alberta.
“It is really a massive scale of spread that’s going on right now.”
It is widely believed by experts and health officials that Alberta’s case counts are higher than the confirmed numbers reflect. A standing exposure advisory remains in effect for the entire south zone and parts of the north due to widespread transmission.
And the Alberta government’s measles website says cases are likely going unreported and undetected.
Saxinger worries about the impact of large summer gatherings such as the Calgary Stampede, which just ended on Sunday.
“I don’t think we’ve seen a suggestion of things levelling off and now there’s large meetings of people and after that school will be back in. So I think there’s still a period of serious vulnerability to increasing numbers for a while,” said Saxinger.
“As an infectious diseases specialist I never would have guessed this was going to happen because measles is supposed to be eradicated.”
The south, north and central health zones have been the hardest hit by outbreaks.
According to provincial data, there had been 102 hospitalizations, including 15 ICU admissions, as of July 5. No deaths have been reported.
The latest national statistics show 58 per cent of the new cases reported during the week of June 22 to June 28 were in Alberta.
“We know that per capita we have more measles cases in Alberta than really anywhere else in North America,” said Craig Jenne, a professor in the department of microbiology, immunology and infectious diseases at the University of Calgary.
“We have heard stories that there may be underreporting in the U.S. but even the fact that we’re close to those numbers is quite concerning given we have almost a hundredth the population.”
Transmission rate
The latest case breakdown shows there have been a total of 774 cases in the south zone, 35 in Calgary zone, 107 in central zone, 13 in the Edmonton zone and 385 in the north.
“Perhaps the more concerning aspect, at least for me, is not the total number of cases, it’s how quickly we’ve gotten here,” said Jenne, who is also the deputy director of the Snyder Institute for Chronic Diseases.
Alberta’s measles outbreaks have snowballed more quickly than Ontario’s, which started in October, according to Jenne.
That province, which has three times the population of Alberta, had confirmed 1,934 as of July 8, with another 310 probable cases.
“It is growing much more rapidly here…[The] rate of transmission is very concerning.”
Mass immunization clinics
Measles is highly contagious and can lead to serious complications, including pneumonia, brain inflammation, premature delivery and even death.
Young children, pregnant individuals and those with weakened immune systems are at highest risk.
“I’m really afraid that we’re going to see terrible outcomes in babies and kids under five because that’s the most vulnerable group across the board,” said Saxinger.
She’s calling on the provincial government to take key steps to rein in the outbreaks, including setting up mass vaccination clinics and campaigns.
“I think there can be a lot of unintended barriers for people who even want to get their vaccines updated…It can be really hard to book actually getting it,” she said.
Saxinger also wants the province to target school-aged children for vaccination before they head back to school in the fall.
And, like other physicians, Saxinger is calling on the province to offer an early and extra vaccine dose to babies as young as six months old in all regions. The extra shot is only being offered in the south, central and north zones.
CBC News asked the government for a response but did not immediately hear back.
Pregnant Albertans, who are at high risk as well, need to know they should seek help if they’ve potentially been exposed, according to Saxinger, and vaccine messaging in general needs to be improved.
“I think it really has to be a big priority for elected officials to remind people, because not everyone watches the news [and] not everyone gets the same information.”
Provincial response
The Alberta government is defending its measles response, saying it’s working to limit further spread and support those impacted.
“Expanded vaccination clinics, targeted outreach, and clear public health guidance are already in place and showing positive results,” an emailed statement from the Ministry of Primary and Preventative Health Services read in part.
Measles clinics hours and locations have been expanded in higher risk areas, according to the spokesperson, particularly in southern Alberta.
“Comparisons to the United States can be misleading, as most U.S. cases this year are concentrated in a single state —Texas … Measles is increasing at different times in various regions as it’s introduced by travellers, as seen in both Texas and Ontario.”
The CDC website shows most states are reporting some measles cases. Texas has reported 753 cases since late January.
“As of now, there are two [Alberta] patients in hospital, and at no point have more than three or four patients been hospitalized at once,” the Alberta government spokesperson said.
“There are currently 13 active cases across the province, and that number has remained stable for several weeks. Three of the five health zones have not seen any significant recent increase in cases. Weekly case numbers have now declined for four consecutive weeks and are roughly half of what they were at the recent peak.”
The Alberta government’s own website explains the “active” case count is an estimate and does not reflect the risk level because it doesn’t account for those who are undiagnosed or who have been exposed.
The Alberta government has also extended its Don’t Get Measles, Get Immunized ad campaign into mid-August and public health teams are calling parents of young babies in the hardest hit zones to let them know their infants are eligible for an early vaccine dose.
The ministry said its efforts are working and between mid-March and early June, the number of vaccine doses administered across Alberta increased by 57 per cent.