A measles, mumps and rubella vaccine is shown on a countertop at a pediatric clinic in Greenbrae, Calif. on Feb. 6, 2015. Measles outbreaks internationally have health officials in British Columbia encouraging people to check their immunization records if they plan to travel abroad during spring break.

Image Credit: THE CANADIAN PRESS/AP, Eric Risberg

VANCOUVER - The first case of measles in British Columbia since 2019 is prompting an exposure alert to residents of Richmond and vaccination reminders to parents and spring break travellers.

Premier David Eby says confirmation of the measles case in a child over the weekend is "terrifying" for parents with infants.

Vancouver Coastal Health says there were potential exposures in Richmond, at the Vancouver Airport Hotel on Westminster Highway from Feb. 24 to March 2, and at the Insurance Corporation of B.C. office on Number 3 Road from 9 a.m. to 1 p.m. on Feb. 26.

It says families with unvaccinated infants, pregnant women and immune-compromised people who may have been exposed should contact their local public health clinic or the Vancouver Coastal Health communicable disease hotline.

Eby joins Dr. Theresa Tam, Canada's chief public health officer, and her B.C. counterpart Dr. Bonnie Henry in encouraging people to get vaccinated before travelling abroad.

Henry says the B.C. infection is related to travel and involves a child under age 10.

At least 16 cases elsewhere in Canada have been reported this year compared with 12 for all of 2023.

Ten cases have been confirmed in Montreal, five cases in Ontario and one in Saskatchewan.

Henry raised concerns about vaccination levels at home and abroad.

"It is concerning that in many countries where the public health systems are not very strong that the measles vaccinations have lagged," she said in an interview Monday.

"We've been doing quite a lot of work in Canada and here in B.C. to try to make up for the immunization that children might have missed in 2020 and 2021."

However, unvaccinated communities are at high risk of outbreaks, as was the case in the Fraser Valley east of Vancouver in 2014, said Henry, adding that undervaccination is also a concern

"Measles is so infectious that in school settings in particular it can spread so quickly. The challenge is it spreads before people know they're sick with it. Four days before the rash starts to four days after the rash starts you can be infectious," she said.

The virus starts with symptoms similar to a cold or flu before the rash appears.

"We forget that measles can cause such severe illness in children," Henry said. "It can lead to encephalitis, or swelling of the lining of brain and the brain itself. It can lead to really severe pneumonia and very sick kids. And it's so easily preventable."

Eby issued a rebuke Monday to people "trafficking in misinformation about vaccines."

"This is terrifying," Eby said at an unrelated news conference in Victoria, when asked about the measles case. "Without those vaccinations you're putting infant children in our province at risk of very, very serious illness."

The premier urged parents to ensure their children are up to date with their shots, saying vaccines "make us safe."

"They make us healthier. They've eliminated diseases like polio," he said.

In B.C., the measles vaccine is given in two doses — first as the measles, mumps and rubella (MMR) vaccine at about 12 months, and then around the time school starts as the measles, mumps, rubella and varicella (MMRV) vaccine.

Some provinces provide the vaccine for varicella, or chickenpox, separately.

The first dose provides between 90 to 93 per cent protection against measles and the second dose gives a lifelong boost, Henry said.

The largest immunization campaign across the country before the COVID-19 pandemic involved a catchup for the measles vaccine in 1997, she added.

Babies as young as six months should be vaccinated against measles before travelling to countries where the disease is spreading, says a joint bulletin issued Monday by Henry's office, the provincial government and the BC Centre for Disease.

Children between the ages of 12 months and four years can also get their second dose before travelling outside the country, it says.

Kids aged four and older can be vaccinated by a pharmacist, and if it's their first dose, immunization is best at least two weeks before travel to give their body enough time to build immunity, it adds.

Vaccine appointments can be booked through local public health units, community health centres or nursing stations as well as some primary care providers, but it's recommended that people call first to check if the measles vaccine is available.

Adults can also be vaccinated by a pharmacist but may already have protection from childhood vaccination or from having had measles, but they should ensure they have received two doses of a measles-containing vaccine if they were born in 1970 or later.

People born before 1970 do not need to be vaccinated because they have immunity to measles from a prior infection, before vaccination was widely available, Henry said.

"I was getting calls from people in their 80s saying, 'Do I need to get a vaccine?' The answer is no."

Students in Quebec started spring break this week while those in B.C. and Ontario will be off as of March 18. Schools elsewhere are closed for spring break in March or April.

Dr. Tam has strongly advised Canadians to be vaccinated with two doses of the measles vaccine, especially before travelling.

"As we head into the spring break travel season, I am concerned that the global surge in measles activity, combined with the decline in measles vaccine coverage among school-aged children in Canada, could lead to an increase in imported measles cases," she said in a statement issued Feb. 23.

"Although measles has been eliminated in Canada, cases can still occur here when an individual who is not fully vaccinated has travelled to or from a country where measles is circulating," the statement says.

The World Health Organization reported a 79-per-cent increase in the number of global measles cases in 2023 compared with the previous year.

— With files from Dirk Meissner in Victoria

This report by The Canadian Press was first published March 4, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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