As of 2023, Canada continues to experience an unprecedented measles outbreak, with more than 3,000 measles cases reported across the country. Ontario’s health-care workers have been forced to carry the weight of this crisis, with more than 2,000 of those infections coming from Ontario. Health officials have called the eruption a “slow burn,” a term that speaks to the slow but steady spread of this outbreak. Front-line workers have been instrumental in managing this health crisis, requiring close collaboration among local hospitals to effectively treat and isolate patients.
Carly Simpson, who lives in the epicenter of the outbreak, knows firsthand the acute impact of the outbreak. She now counts herself among the “unlucky ones” who caught measles despite being vaccinated. Simpson was fully vaccinated with three doses, and she expected the vaccine to provide her with strong protection. Little did she know that she would be bedridden for days before succumbing to the mildest of symptoms.
Dr. Ninh Tran, a physician treating measles patients, first noticed white spots inside his cheeks in late April, followed by a red blotchy rash that spread from his forehead down to his shoulders and arms. This is a sobering personal experience that describes the highly contagious nature of the virus and how it can spread through variants, even in those who are vaccinated.
Dr. Erica Van Daalen, another central figure in the effort to contain the outbreak, discussed the complicated considerations that come with treating a measles patient. She noted that decisions regarding discharging children with measles often lead to sleepless nights, stating, “You hesitate to send them home because you’re not quite sure how they’re going to land.”
This outbreak has put enormous strain on health practitioners. For Dr. Tran, commenting just after case numbers shot through the roof in late February, feelings of burnout were palpable. By the end of February, this number almost doubled to 177 weekly measles cases in Ontario. This frightening spike became cause for serious concern among healthcare workers and the surrounding community.
Despite these challenges, there are signs of hope. By mid-June, new case numbers started to drop off dramatically. Dr. Tran commented on this development, saying, “While it’s still early to confirm a persistent pattern, the consistency of the decrease does suggest a potential shift in the trajectory of the outbreak.”
Moreover, front-line health workers have described unique challenges created in meeting patient care needs during this pandemic. Some people caught measles by presenting for care with nonspecific symptoms, making it even more difficult to contain the outbreak. Sangavi Thangeswaran, a nurse, explained their approach to minimize exposure: “We ask the patient to stay in there. When they are unable to go to the washroom, we offer commodes or urinals. This is key to reducing their overall exposure.
Beyond the physical health impacts, the emotional toll of the outbreak has been immense. Dr. Tran called the space between medical professionals, at the time, fearful and stressful. “You could sense a bit of tension and anxiety in all this discussion,” he remarked.
Shawn Cowley was among those impacted by the outbreak. After his diagnosis, he was confronted with the scary possibility that he had put others at risk for getting measles. He reflected on this burden, stating, “When you find out you do potentially have measles, and the number of people I’ve exposed, understanding how virulent measles is, that’s a really hard thing to deal with personally because you put other people at risk.”
The effects of measles go far beyond the acute disease itself. Dr. Van Daalen warned of potential long-term consequences for children who contract the illness, stating, “There are some later-term consequences for kids who have measles. It’s a very rare complication, but we’ll have to keep our surveillance up.”
Less than seven percent of Ontario’s measles cases have required hospitalization. The outbreak provides a reminder of the importance of vaccination and community health prevention measures.
