Latest news with #DawnBowdish
CBC
6 days ago
- Health
- CBC
Doctors warn of 'frightening' measles complication that can strike a decade after initial infection
As Alberta's measles case counts soar, doctors and scientists are warning parents about the long-term and lesser-known complications of measles. And they can be deadly. As of midday Wednesday Alberta had reported a total of 749 cases since the outbreaks began in March. What many parents may not realize is that a rare and debilitating neurological condition, called subacute sclerosing panencephalitis (SSPE) can develop long after a child recovers from measles. "It just frightens the heck out of me," said Dr. Sam Wong, an Edmonton-based pediatrician and president of the section of pediatrics with the Alberta Medical Association. "Thankfully it doesn't happen very often but, when it does, it's devastating." Most people can clear the measles virus once their infection is over. But in some very young children, or people who are immune-suppressed, the virus hides out in brain cells and develops mutations that allow it to stay invisible to the immune system, according to Dawn Bowdish, a professor of immunology at McMaster University. Brain inflammation It can eventually flare up, causing brain inflammation, causing children or young adults to lose the ability to move and speak. "It starts destroying the cells of the brain — there's no treatment, there's no way to repair a broken brain — and so eventually they can end up in a coma and then they will die of it," said Bowdish. According to the Public Health Agency of Canada, SSPE occurs in between four and 11 out of every 100,000 measles cases. Health officials say it strikes between seven and 11 years after an initial infection and the highest rates are among children who contract measles before the age of two. "One of the reasons we're so universally stating that people need to be vaccinated is because some of these long-term effects are just so grim," said Bowdish. Alberta's routine childhood immunization schedule recommends babies receive two doses of measles vaccine, with the first administered at 12 months and the second at 18 months. The province is offering an extra, and early, dose of the measles vaccine to babies as young as six months old who are living in the south, central and north health zones, where the current outbreaks are most intense. As the lead medical officer of health for Alberta Health Services in the South Zone, Dr. Vivien Suttorp worries about young babies whose mothers are unvaccinated. Typically, antibodies are passed along to the fetus during the third trimester, which protect them during their first few months of life, she said. But if a mom isn't immunized, the baby won't have that early protection. "They're extremely vulnerable to getting measles after birth ... and of the complications," she said, pointing to SSPE. "That's very concerning. And there is no treatment for that." According to Alberta Health, SSPE declined with the widespread adoption of measles immunization decades ago. Three cases of SSPE were reported in Alberta in 1984, followed by one case in in 1986, one in 1990 and one in 1992. No cases were reported from 1993 to 2013. In 2014, there was one more case reported in a woman who was born outside of Canada with an unknown history of measles immunization. Immune memory impacts In recent years, measles vaccination rates in Alberta have declined, and experts say that has paved the way for surging outbreaks. "Another curious complication [of measles infection] is immune amnesia," said Suttorp. Measles can wipe out a person's immune memory, she said, and make people more susceptible to other infections for months and even years. "So not only when someone has measles are they at higher risk for an infection like a bacterial pneumonia … but this also happens up to two to three years later," said Suttorp. "There is a memory loss of viruses and bacteria that someone has been exposed to before and mounted antibodies to." Bowdish said this this longer-term immune system complication happens because measles infects and kills a specific type of immune cells. "We know that people who've had measles tend to need more doctors appointments, more antibiotics and they're more susceptible to other infections for months to years to follow because measles destroys the very immune cells that we use to protect ourselves," she said. According to Bowdish, more severe initial infections trigger the loss of more immune cells and make the long-term impacts worse. She's particularly worried about infants under six months old,who are too young to be vaccinated. "Those are some of the people who are the most likely to have these really rare and severe complications," said Bowdish. "There is nothing we can do except vaccinate the people around them to protect those really, really young babies." These long-term complications are in addition to the risks that come during the initial infection, which include ear infections, pneumonia, brain swelling and death. Measles infections are fatal in roughly one to three out of every 1,000 cases, according to the Alberta government. Provincial data shows most of this year's cases are among children (569 of the 749 cases this year are under the age of 18). And the vast majority of cases are among people who are unimmunized. "Please vaccinate your child," said Wong. "It's very concerning from my point of view that, as the numbers increase, the risk of these longer-term side effects will increase, because it's a numbers game." Measles symptoms include: High fever. Cough. Runny nose. Red eyes. Blotchy, red rash that appears three to seven days after the fever starts. In darker skin colours, it may appear purple or darker than surrounding skin. Alberta Health provides detailed information on measles case counts, symptoms and free immunizations here. A list of possible exposure alerts can be found here and a measles hotline is available for people with questions about symptoms, immunization records or to book an appointment: 1-844-944-3434. A standing measles exposure advisory remains in effect for southern Alberta, due to widespread transmission in the region.
Hamilton Spectator
02-05-2025
- Health
- Hamilton Spectator
Hundreds more Hamilton students out of class for vaccine suspensions
More than a thousand Hamilton students missing vaccination records were suspended in what public health has said is the final wave for the school year. On Friday, 1,215 elementary students at Catholic schools, as well as students at French and private schools, were removed from class, associate medical officer of health Dr. Brendan Lew said in an email. Seven hundred of this group remained suspended as of Monday. This is the third round of post-pandemic enforcement, which numbers show has been effective in ensuring records are up to date. Of the 3,197 Hamilton-Wentworth District School Board elementary students missing records in January, 76 hadn't complied following suspensions of up to 20 days, the maximum time permitted under the Immunization of School Pupils Act. Among public and Catholic high school students, 316 were still missing records after 20-day suspensions, down from 7,615 in March. To comply with the act, Ontario students must submit proof of vaccination against nine illnesses — diphtheria, mumps, tetanus, polio, rubella, pertussis, varicella (if born after 2010), measles and meningococcal disease — to public health units, or request an exemption for medical or religious or philosophical reasons. As of late March, 4.5 per cent of Hamilton students were exempt, up from less than 2.5 per cent about a year ago and nearly three per cent before the pandemic in 2018-19. It's a 'worrisome' figure, Dawn Bowdish, a professor in the department of medicine at McMaster University, said at the time. The March rate was lower among elementary students at 3.9 per cent, and higher among secondary students at 6.3 per cent. About six per cent are exempt in Haldimand-Norfolk, the location of a measles outbreak of more than 100 cases, The Spectator reported in March. The highly contagious disease continues to spread in Ontario, with one case confirmed in Hamilton earlier this year. In Brantford and Brant County, the exemption rate is lower at about four per cent. Students without records or an exemption return to school after 20 days and 'would be subject to future enforcement' in future school years, Lew said. Public health will continue to remind these families to update their records. Planning for next year is 'ongoing,' he said, noting that elementary cohorts that didn't undergo enforcement this year, which includes those born between 2013 and 2016, will be prioritized.
CBC
29-04-2025
- Health
- CBC
Niagara region hospitals aim for every newborn and child without a family doctor to go home with one
Newborns in Niagara region without access to a family doctor will be connected to those accepting patients through a new hospital program. Called a "pediatric pathway," Niagara Health said it also created the program to help children who are hospitalized, and those with complex care needs, access primary care. When many infants and kids, under 18-years-old, leave the hospital, they don't have a family doctor to support them, said Niagara Health in a news release Tuesday. Under the new program, they and their parents or guardians will be provided with information about physicians and community health centres where they can become patients. And for children with complex care needs, pediatricians at the hospital will work closely with the family physician to continue providing support. "This pathway is about making sure no child falls through the cracks," said Dr. Madan Mohan Roy, chief of pediatrics at Niagara Health, in the statement. "Our goal is to ensure that every pediatric patient, regardless of their situation, has access to continuous, community-based care after they are discharged." Family doctor shortage linked to measles outbreak Children with a family doctor have better access to vaccines, developmental monitor, early detection of health concerns and a contact to support them with everyday health needs, Niagara Health said. It also helps families avoid "unnecessary hospital visits." About 2.5 million people in Ontario do not have a family doctor, including roughly 360,000 children according to research in 2024 and 2023, respectively, by the Ontario College of Family Physicians. If a baby is born to parents with a family doctor, he or she could become that doctor's patient. But if the parents don't have a family doctor, the baby could also be without. The family doctor shortage has contributed to the measles outbreak in Ontario, with many cases in the Grand Erie region, according to local experts. The region includes the City of Brantford and counties of Haldimand, Norfolk and Brant. "It's availability. It's the family doctor crisis. It's the not being able to get vaccines at a time that works with their work schedule," Dawn Bowdish, a professor of medicine at McMaster University, told CBC's The Current in March. "The Canadian situation is one in which outright refusal is actually comparatively rare. It's access and availability and convenience that tend to be the drivers of this fallen vaccination rates." Doctors accepting new patients There are currently more than 30 family doctors in the Niagara region accepting new patients, said Dr. Jennifer Robert, chief of primary care, said in the news release. "That's an important opportunity many may not be aware of," she said. "By connecting community members with these providers, we're not only improving individual health outcomes — we're supporting a stronger, more connected healthcare system." Physicians who accept new patients through the new hospital program so far include four in St. Catharines, three in Welland and one in Fort Erie, as well as through community health centres across the Niagara region. Niagara Health said it is looking to create a similar program for adults.
CBC
24-04-2025
- Health
- CBC
Do I need a third dose of the measles vaccine? And other common questions answered
It's only April, and 2025 is already shaping up to be the worst year for measles since the disease was declared eliminated in 1998 in Canada. Ontario continues to be the epicentre of the spread. Public Health Ontario is reporting 1,018 confirmed and probable cases of measles so far this year. The vast majority of those infected were not fully immunized. Six unvaccinated children and adolescents have been hospitalized with the virus. In Alberta, too, the virus is spreading. The province is reporting 129 cases as of April 24, in every zone in the province. In that province, most of those sick are not fully vaccinated. Nine people have been hospitalized. Measles is one of the most contagious diseases known to man. Symptoms can include a fever, coughing and a runny nose, as well as a blotchy red rash. In serious cases, measles can cause complications like inflammation of the brain, pneumonia and death. As the virus spreads, here are some common questions about immunity to measles, answered. Can measles immunity wane? Two doses of the measles, mumps and rubella (MMR) or measles, mumps, rubella and varicella vaccine (MMRV) offer almost 100 per cent effectiveness in the long term. Even so, immunologist Dawn Bowdish says she's been fielding questions about waning immunity from those worried they are not perfectly protected from the virus. "Most of us who were born after 1970 have never encountered measles; we've only been vaccinated. We know that a small percentage of people in that scenario will have some decrease in immunity," she said. That could mean some breakthrough infections can happen among those who received two doses of a measles vaccine. It's a numbers game: the more measles is spreading, the more likely it is that a breakthrough infection happens, says Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta. "People who have had two doses are substantially protected, but not bulletproof." Even when those who are fully vaccinated get an infection, they're less likely to suffer the most serious consequences, says Dr. Dale Kalina, chief medical officer at Brant Community Healthcare System in Brantford, Ont., an area that has had measles cases since January. "The reality is [those who've received two shots] aren't the people I would be worried about in an outbreak, from a spread perspective, nor from a complications perspective or a need for hospitalization," he said. How can I check whether I am protected against measles? There is a blood test that looks for antibodies against the measles. Whether to get it or not is a conversation people need to have with their family doctors, says Bowdish. Health-care workers or those who work with vulnerable people often get tested for antibodies, as do some pregnant women. Bowdish says she'd like to see that be the standard of care across the country, because measles used to be a major cause of lost pregnancies, stillbirths and birth defects in areas of the world with patchy vaccination rates. "As we move to an era where we have a lot more measles around, I personally am very supportive of pregnant women, or people who are planning on starting a family, getting this test." WATCH | Getting your child vaccinated: How early can you get your child vaccinated against the measles virus? 24 days ago Duration 3:49 Measles cases in B.C. remain low, with just five confirmed cases — all of them travel-related. But elsewhere, the numbers are exploding. Experts warn of further spread due to low vaccination rates. CBC's medical columnist, Dr. Melissa Lem, says she's been fielding questions from concerned parents. She says school-age kids are particularly vulnerable, and the virus can leave lasting damage to lungs and the immune system and even cause brain damage. Those who are not sure if they've been fully vaccinated, though, are better off getting another dose, instead of getting the blood test, says Bowdish. "If you can't find your vaccination status, if you came from parts of the world that don't have the childhood measles [vaccinations], if you're worried that your parents might not have vaccinated you as a child — our recommendation is just get vaccinated," she said. Those who are born before 1970 are generally believed to be protected, says Bowdish, because they were exposed to measles as children. Do I need a third dose of the measles vaccine? Canadian public health authorities don't recommend a third dose of the MMR vaccine for the general public, even though it's generally safe. That's because it wouldn't make sense to prioritize the limited time and public health resources we have to give a third dose right now, Bowdish says. There are some exceptions, like those who are on immunosuppressive drugs, or cancer treatments, Bowdish says. But those decisions should be made after a conversation between the patient and their doctor. Saxinger agrees. "Making sure that ... people who are unvaccinated get vaccinated first is kind of the clear priority. There might be a time when we would start looking at the utility of additional doses for more people, but I don't know if it's quite now."
