A second case of measles reported in Manitoba earlier this week is a rare and troubling event.
Not since 1992 has there been more than a single case of measles in the province in a given year -- and almost never in that time has it been home-grown. Usually, travellers have brought the highly contagious virus back with them from abroad.
But this year's situation is different.
The 40-something man who contracted the disease first had not travelled out of province, public health officials say. He then passed it on to a second man in his 20s, they've concluded.
'We want to get in front of this as much as we possibly can' -- Dr. Michael Routledge, the province's chief public health officer
Officials aren't panicking about the two instances. But on the day the second case was announced, they penned a letter alerting parents about the disease. The letter is being distributed in schools and daycares in Manitoba.
Dr. Michael Routledge, the province's chief public health officer, said Thursday the intent isn't to frighten parents, but to prevent the spread of the virus and to encourage vaccination.
"We want to get in front of this as much as we possibly can," he said of a potential measles outbreak.
During the last few years, Quebec, Alberta and, most recently, British Columbia have seen significant measles outbreaks. B.C.'s Fraser Valley has reported 228 cases this year. Much of this activity has been traced to the Netherlands and the Philippines.
"Am I concerned that we're going to have a lot of cases? Not particularly," Routledge said Thursday. "Am I concerned that we could have more? I certainly wouldn't be surprised if we had more."
The letter to parents says the best way for them to protect their children is to make sure they are up to date with their immunizations. The vaccinations are free.
The missive also warns parents may be asked by health or school officials to keep their child home for up to three weeks if they show signs and symptoms of the illness. These include fever, cough, runny nose or red eyes and a red blotchy rash appearing three to seven days after the fever starts -- usually on the face and spreading down the body.
Several years ago, Canada appeared to be heading toward the elimination of measles, but that has not panned out as immunization rates have levelled off.
Some parents have kept their kids from being immunized out of fears that a preservative used in a combination vaccine (for measles, rubella and mumps) might cause autism. But Routledge said that theory has been "completely and unequivocally refuted."
While measles immunization rates in Manitoba have remained fairly stable in the past decade, an analysis by the Manitoba Centre for Health Policy (MCHP) noted small declines between 2002 and 2007 in such Winnipeg neighbourhoods as River Heights, St. Vital, Seven Oaks and St. James-Assiniboia.
Alan Katz, an MCHP researcher, said there appears to be "an anti-immunization movement" within certain segments of the population.
He said this is concerning because of the overwhelming evidence of the benefit of immunization.
Routledge said high immunization rates are the best protection against measles. "A lot of people say that these are benign diseases, but they're not. At minimum, they make you quite sick. And at worst, they can do a lot worse than that," he said.
Measles can lead to such complications as ear infections, diarrhea, pneumonia and encephalitis (inflammation of the brain).
The disease tends to be more severe in infants and young children and can be life-threatening.
Routledge said the man in his 40s who contracted the illness was hospitalized but was sent home. Health officials would only say he lives in the area served by the Interlake-Eastern Regional Health Authority. The second victim, a Winnipegger, is recovering at home, too.