Canada is currently dealing with outbreaks of measles, with cases confirmed in Nova Scotia, Ontario and BC, and while health officials say the public should not be alarmed, growing anti-vaccination sentiment in Europe may bring worry about the further spread of infectious diseases like the measles and mumps.
With six cases of the measles so far confirmed in Nova Scotia, health authorities are putting the blame on lower vaccination rates among adults between the ages of 20 and 40. Dr. Trevor Arnason, Medical Officer of Health for Halifax, Eastern Shore and West Hants, told the CBC that while vaccination rates are strong for the younger cohort of Nova Scotians, because of immunization routines in the 1970s and early 90s adults between the ages of 20 and 40 may have only received one shot of the measles/mumps/rubella vaccine, where the accepted practice now calls for a second dose. “This is the group that we are seeing being affected … these adults in their 20s and 30s,” Arnason said.
In Ontario, one case of measles has been confirmed in Kingston, while Toronto Public Health recently issued a statement saying that it is investigating three confirmed cases, one of which turned out to be a Westjet crew member. Passengers on certain Westjet or Emirates Airline flights earlier this month are being advised to check their immunization records and watch for symptoms.
The cyclical nature of infectious diseases such as the measles and mumps means that some years will be worse than others, although nothing like pre-immunization years which saw thousands of cases of the diseases per year, with hundreds of deaths in Canada each year from measles alone.
“Mumps and measles are very contagious illnesses…at the moment we have this particular issue with people who’ve only had one dose of vaccine. For this age group, it’s a good time to check and make sure they’ve had two doses,” said Dr. Allison McGeer, director of infection control at Toronto’s Mount Sinai Hospital, to NiagaraThisWeek.
Dr. McGeer asserts that the recent outbreaks in Canada are not overly worrisome but they are reminders of the importance of vaccination. “The fact that you can still get clusters of cases is a marker for just how important having those vaccination programs is. If they didn’t happen then everybody got sick,” says Dr. McGeer.
Meanwhile in Europe, measles outbreaks are occurring in greater numbers this year, attributed in part to a growing cohort of parents who have decided not to vaccinate their children, a trend that the World Health Organization calls “dangerous.”
“Today’s travel patterns put no person or country beyond the reach of the measles virus,” said Dr Zsuzsanna Jakab, WHO Regional Director for Europe. ”Outbreaks will continue in Europe, as elsewhere, until every country reaches the level of immunization needed to fully protect their populations.”
The WHO reports that in Romania, 3,400 cases have been reported since January 2016 along with 17 deaths and in Italy there has been a “sharp rise” in cases during the first few weeks of 2017, with 238 measles cases reported.
While anti-vaccination sentiment has caused immunization rates to fall in countries like Japan, the Philippines and the United States, Europe has been especially targeted for its poor rates, with countries like France (74 per cent immunized) and Ukraine (57 per cent immunized) at the lower end of the spectrum.
Explanations for the lowering rates are varied. In Romania, part of the blame is falling on celebrities like former TV presenter Olivia Steer (who has called vaccines a “myth”) while poverty and a lack of access to health services are also thought to be playing a role.
But in countries like France and Italy where access to adequate health care services is less of an issue, a range of factors have been pointed to, including rising support for the populist Five Star Movement (M5S) in Italy, which has campaigned on an anti-vaccination platform as well as a general lack of public concern about the severity of such infectious diseases.
“We are seeing increasing ‘vaccine hesitancy’ in parts of Europe,” Lucia Pastore Celentano, head of the Vaccine Preventable Disease Program at the European Center for Disease Control or ECDC, to the Daily Beast. “This is different to being an ‘anti-vaxxer’. Vaccine-hesitant individuals hold varying degrees of indecision about specific vaccines or vaccination in general. This is a result of a lack of trust in the vaccine or the healthcare provider, complacency towards the disease itself, because we no longer have direct experience of the diseases, and the inconvenience of taking a child to be vaccinated,” said Pastore.
In the United States, where vaccination rates had recently begun to improve after languishing for years as a result of anti-vaccination efforts, fears are growing once again. The new Health and Human Services Secretary, Tom Price, is a noted member of the Association of American Physicians and Surgeons, a group which opposes mandatory immunizations. In March, when asked whether he thought all children should get immunized against vaccine-preventable diseases like the measles, Price replied in, to his critics, a less than favourable manner. As well, current president Donald Trump has made past public statements against vaccination.