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This week |  | | Measles has exploded in Europe. Clinicians say it's only a matter of time before outbreaks hit Canada |
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| | Is misunderstanding of mental illness clouding MAID expansion? |
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| | Debate over access to gender-affirming care plays out in Alberta |
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 | A Yemeni child receives treatment for measles in the Huthi-rebel-held Yemeni capital Sanaa, on March 21, 2021. (AFP/Getty) | | Measles has exploded in Europe. Clinicians say it's only a matter of time before outbreaks hit Canada
Global travel, slumping vaccination rates has led to post-pandemic surge of infections | Lauren Pelley and Amina Zafar
| After an explosion of measles cases in Europe, medical experts say it's just a "question of time" before outbreaks happen in Canada, thanks to high rates of global travel and low rates of vaccinations.
There were 42,200 measles cases across more than 40 European countries last year, the World Health Organization (WHO) announced this week — a more than 40-fold increase from 2022, which saw fewer than 1,000 cases. In December, the organization said there had been more than 20,000 hospitalizations and at least five deaths in the European region.
Globally, the situation is even grimmer, with a spike in infections in 2022 that included nine million known cases and 136,000 reported deaths, mostly among children.
The WHO said the rise in cases in Europe has accelerated in recent months, and the upward trend is expected to continue if urgent measures — like vaccination efforts — aren't taken to prevent further spread of this potentially deadly infection.
"It's not something that is mild," said Dr. Kate O'Brien, a Canadian pediatric infectious diseases specialist and director of the WHO's department of vaccines and immunization. "And it's not something to be taken lightly."
The risk in Canada
Canada eliminated measles back in 1998 through widespread vaccination programs.
Here, the vaccine is given to children as two doses of a combined shot that also protects against a combination of infections — either measles, mumps and rubella, or measles, mumps, rubella and varicella.
The annual case count remains small — only a dozen confirmed infections were reported country-wide in 2023 — and most cases are now acquired through travel outside the country.
But clinicians say outbreaks are still a risk. Canada, like many other countries, hasn't hit the 95 per cent vaccination coverage required to prevent its spread.
"Measles is probably the most infectious human virus that is known, and as a result, in order to prevent measles infections, vaccination rates have to be really high in a community," said O'Brien.
"What's happened is, over the course of the pandemic, we've had a historic backsliding in the immunization rates around the world." | |  | A mother and her daughter wait at a community health centre to complete their vaccination schedule, in Caracas, in 2022. (Yuri Cortez/AFP/Getty | Vaccination catch-up crucial
In Europe, the level of coverage with two doses of the measles vaccine dropped from 92 per cent in 2019 to 91 per cent by 2022, WHO data shows. Nearly two million infants also missed their measles vaccination in the first two years of the pandemic.
That means children are particularly at risk, clinicians say. Measles spreads easily through the air, leads to high hospitalization rates, and can cause a hacking cough, high fever and a prominent rash. In more serious cases, it leads to pneumonia, brain damage, and death in up to three out of every 1,000 children infected.
Infections can have wide-ranging and sometimes lifelong consequences, including blindness, deafness, or immune system impacts that leave people vulnerable to other infections.
In the U.K., where there have been hundreds of cases in recent months, including 127 reported infections in January alone, health officials also point the finger at "falling" vaccination coverage. One in 10 children start school in England without protection.
That's similar to Canada. Federal data from 2021 shows that 79 per cent of children had two doses of measles, mumps, and rubella vaccine by their seventh birthday, down from 83 per cent in 2019 and 87 per cent in 2017.
That suggests close to two in 10 children hadn't yet had their full set of shots — far from Canada's target of 95 per cent coverage for that age group.
"Right now we're underneath the level of immunization that we need to prevent onward transmission in Canada," said pediatric infectious diseases specialist Dr. Charles Hui, who works with CHEO and the University of Ottawa.
Another study on population immunity in Ontario, published in 2019, found nearly eight per cent of blood samples had antibody levels below the threshold needed to ward off a measles infection. This suggested that immunity in some age groups may be waning "despite high vaccine coverage."
And clinicians warn the situation is getting worse.
Read more about the threat of measles from CBC Health's Lauren Pelley and Amina Zafar. |
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Cross-Canada health news from CBC | | Manulife-Loblaw deal raises questions over ties between insurance companies, big drug retailers | CBC Business |
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| | B.C. should expand safer-supply program despite drug diversion risks: provincial health officer | CBC British Columbia |
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| | National dental care plan registration expands to cover seniors 72 and older | CBC Politics |
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 | Graeme Bayliss, an advocate for medical assistance in dying (MAID) for people with mental illness, says he finds the possibility of an assisted suicide comforting. (Submitted by Graeme Bayliss) | | Is misunderstanding of mental illness clouding the expansion of MAID in Canada? | | Canadians suffering from debilitating mental illness cannot yet legally qualify for medical assistance in dying, unlike almost all others with severe illnesses — a restriction some advocates feel is rooted in misunderstanding.
Eligibility for MAID was set to expand in March to include people with mental illness.
But on Thursday, Health Minister Mark Holland introduced legislation that will delay the expansion of assisted dying to include those suffering solely from mental illness to 2027.
Meanwhile Graeme Bayliss wants the right, at some point, of a doctor-assisted death. The 34-year-old has lived with depression and obsessive compulsive disorder since his teens and says he is currently managing. But he says he finds the possibility of MAID as a way out comforting, and makes him more willing to try new treatments and medications should he face tough times again.
Read more from CBC Health's Amina Zafar. | |
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Trending studies | | | Organ donation after medical assistance in dying, from 2018 to 2022 in Quebec | CMAJ |
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| | | Analysis of coronaviruses carried by bats in Southern China to better understand the coronavirus sphere | Nature Communications |
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 | | Alberta's policy changes on gender-affirming care | | 1:55 |
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Gender health practitioners talk to CBC News about Alberta's policy changes | THE NATIONAL | CBC Health's Tashauna Reid spoke to medical experts and patients about gender-affirming care, and the potential impact of Alberta's proposed new law on impacted youth. Limiting access to care, some say, will put kids at risk of self-harm. | |
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THE BIG NUMBER
| 9.7 million | | That was the number of global cancer deaths in 2022, the World Health Organization's cancer research agency said on Thursday. There were also 20 million estimated cases, with around one in five people developing cancer in their lifetimes.
But that burden isn't felt equally around the world.
For example, in the most-developed countries, such as Canada, approximately one in 12 women get breast cancer in their lifetimes, but only one in 71 women die from it.
In countries that are lower on the human development index, such as Jamaica, Cameroon and Papua New Guinea, one in 27 women get breast cancer — but one in 48 women die from it. | |
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Stories we found interesting this week | | Scientists document first-ever transmitted Alzheimer’s cases, tied to no-longer-used medical procedure | STAT |
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| | Children at centre of dangerous mpox outbreak ‘accelerating’ in DRC | The Telegraph |
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| | Heat and wildfire smoke are even more harmful when combined, a study says | New York Times |
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|  | New episode dropped Feb. 1
Dopamine is often associated with helping us feel pleasure, though its role in the body is far more complex. The neurotransmitter is essential for memory and learning, as well as reward-related behaviours — some of which can be problematic.
Patricia Di Ciano, a scientist with the Centre for Addiction and Mental Health, breaks down how dopamine functions, and whether dopamine "fasting" actually works.
Play on CBC Listen |
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|  | New episode airs Feb. 3 and 4
A growing chorus of women is advocating for breast cancer screening to begin at age 40, while the Canadian Task Force on Preventive Health Care guidelines recommend regular screening should start a decade later.
As the task force reviews its guidelines, breast cancer survivors Shannon Coates and Carolyn Holland hope lending their voices can help win the debate.
Tune in on CBC Listen |
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| | Thanks for reading! You can email us any time at secondopinion@cbc.ca with your comments, questions, feedback or ideas. | |
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