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Category "Vancouver Coastal Health"

7Mar

Measles: Latest case located in Fraser Valley, linked to outbreak

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18Feb

Measles in BC: Timeline and what you need to know

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Not long ago, measles cases were far and few in between.

There were two cases in 2016 and just one in 2017. There were six cases confirmed in 2018.

The last outbreak of measles in B.C. was in 2014 when 343 cases were reported. Those cases were linked to an outbreak in a religious community that objects to vaccination.

Last week, Vancouver Coastal Health declared a measles outbreak in the city after as many as nine cases were reported in Vancouver.

Here’s how we got here and what you need to know.



Vancouver Coastal Health has declared a measles outbreak in Vancouver.

Sean Gallup /

Getty Images

Timeline

January / February 2019: An individual who has been confirmed as having measles visited the emergency room at B.C. Children’s Hospital during the following times:
• Jan. 21, 2019 – 10 a.m. to 6:10 p.m.
• Jan. 23, 2019 – 4:45 p.m. to 11:10 p.m.
• Jan. 24, 2019 – 8:13 a.m. to 11:40 a.m.
• Feb. 1, 2019 – 2:05 p.m. to 6:55 p.m.
If you also visited on those days during those times, contact your health care provider.

Jan. 25, 2019: Washington state declared a state of emergency due to the measles outbreak. As of Feb. 17, a total of 62 cases were confirmed, but there was no evidence the cases in Washington are linked to those in B.C.

Feb. 9, 2019: The first B.C. case of measles leading up to the current outbreak was confirmed. By the time this case was confirmed, it was past the point of being infectious.

Feb. 13, 2019: VCH announced a second case of measles was confirmed in the city; there are no indications it is linked to the first case. The patient was a school-aged child who was infected locally, not while travelling abroad.

Feb. 14, 2019: An online petition calling on the province to make vaccinations mandatory in B.C. schools has picked up traction. Just one day after the second case of measles was announced, the petition had already garnered more than 1,800 signatures. Another five days later, the petition now has nearly 27,000 signatures.

Feb. 15, 2019: Health officials confirmed there were several cases of measles at three French-language schools in Vancouver: École Jules‐Verne, École Anne‐Hébert and École Rose-Des-Vents. The cases are occurring in staff, students and family members linked to the schools.

More to come.



A symptom of measles includes a rash that starts on the torso and spreads to the limbs.

PROVINCE

What’s the deal with measles and what should I know?

Measles is highly infectious. Highly. It can be spread through coughing, sneezing, breathing the same air as an infected person, sharing food or drinks, sharing a cigarette and yes, even through kissing a person with measles.

The measles virus can survive for several hours in small droplets in the air.

Most people will recover but those with a weak immune system or infants could experience serious complications. Those could include encephalitis (an infection and swelling of the brain), meningitis, pneumonia, deafness and infection of the liver.

Measles in B.C. is usually rare and linked to cases of unvaccinated residents returning from overseas travel.

How do I know if I have measles?

The incubation period is about 10 days and the symptoms include fever, cough, runny nose and red eyes, followed by a rash that starts on the body and spreads to the limbs. The rash lasts at least three days. You may also have small white spots inside your mouth.

The symptoms can begin as early as a week after being infected.

Some people may have measles, be infectious and not even know it. Those who are infected can spread the virus anywhere from four days before to four days after a rash appears.

How do I protect against measles? How do I know whether I’ve been vaccinated?

Health officials recommend two doses of the MMR (measles-mumps-rubella) vaccine to be fully protected against measles. The first immunization is usually received at the age of one, while the second usually comes before starting kindergarten.

If you’re unsure if you’ve been vaccinated, the first stop is to check your health records.

Born in or after 1994 here in B.C.? You’re likely to be immune because those born in or after 1994 here in B.C. will have had two doses of the MMR (measles-mumps-rubella) vaccine, the first dose when they turn a year old and a second before starting kindergarten, as part of routine vaccinations.

Born between 1970 and 1994? Grew up outside of B.C.? You may have only received one dose of the MMR vaccine. You’ll need a second dose to be protected.

Born before 1970? Or you’ve already had measles in the past? You’re likely to be immune.

Can’t remember if you’ve had one or two doses of the vaccine? The Canadian Centre for Disease Control says adults who do not have evidence of immunity should get at least one dose of MMR. It’s entirely safe to get the vaccine again.

I’m not vaccinated and I’ve been exposed to measles. What now? How do I treat it?

If you’ve been exposed to measles and you’re not vaccinated, you’ll need to get a dose of the MMR vaccine within 72 hours of exposure to prevent the illness.

But wait – don’t go to the emergency room or a doctor’s office without calling first. You’ll be highly contagious and the last thing you want is to spread it even further. Calling ahead will allow doctors make arrangements for your arrival and to ensure you’re isolated from other vulnerable patients.

–with files from Tiffany Crawford, Postmedia

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13Feb

Second case of measles reported in the Vancouver area

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Students at Fleetwood Park Secondary School in Surrey are being told to stay away from class if their measles immunization is not up to date.


Sean Gallup / Getty Images

A second case of measles has been confirmed in the Vancouver area.

It was transmitted locally, meaning the patient was not infected while travelling abroad, Dr. Althea Hayden of the Vancouver Coastal Health Authority said at a news conference on Wednesday. She would not give details about the patient but said they are a school-age minor.

The other case, acquired abroad, was confirmed on Saturday but past the point of being infectious. Hayden said there is no clear link between the two cases. Her health authority’s region includes Vancouver, Richmond, the North Shore and the Sunshine Coast.

“We are working very hard to find out how measles may have been introduced into our community,” she said. “We would be much less concerned about it if we knew exactly where it came from.”

The health authority last released a public measles alert in September, after an infected person attended the Skookum Festival.

Spokespeople at the Fraser, Interior, Island and Northern health authorities said Wednesday that they had not heard of any suspected or confirmed cases of the disease in their regions.

In the State of Washington, a surge in measles cases prompted Gov. Jay Inslee to declare a state of emergency on Jan. 25. As of Wednesday, 54 cases had been confirmed. Health officials are urging residents to get immunized. Four more cases have been confirmed in Oregon.

Measles spreads through the air when an infected person coughs or sneezes, according to Vancouver Coastal Health. Complications can include inflammation of the brain, convulsions, deafness, brain damage and even death.

Infection does not require close contact and measles can survive in close areas, such as a bathroom, for up to two hours after an infected person has left. It causes fever, red eyes, coughing, a runny nose and a rash. Most people recover within a week or two.

Measles is easily prevented through vaccination, which Vancouver Coastal Health recommends. People who have previously had the infection do not need immunization.

B.C. children born in or after 1994 routinely get two doses of the measles, mumps and rubella (MMR) vaccine, one dose when they turn a year old and another before they start kindergarten.

People born before 1994 or who grew up outside of B.C. may need a second dose. People born before 1970 are likely immune; but if they aren’t sure whether they have had the infection, they can safely get the MMR vaccine.

The World Health Organization named “vaccine hesitancy” one of its top 10 threats to global health in 2019. Measles saw a 30 per cent increase in cases globally between 2016 and 2017, and a resurgence in some countries that were close to eliminating it, according to the organization.

“The reluctance or refusal to vaccinate despite the availability of vaccines – threatens to reverse progress made in tackling vaccine-preventable diseases,” according to the WHO. “Vaccination is one of the most cost-effective ways of avoiding disease – it currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved.”

In Canada, immunizations are not mandatory. But Ontario and New Brunswick require proof of immunization for children and adolescents to attend school, according to Immunize Canada.

In the U.S., all 50 states and the District of Columbia have laws that require children entering childcare or public schools to have certain vaccinations. All state laws provide medical exemptions, 17 states allow religious or medical exemptions only, and five states expressly exclude philosophical exemptions, according to the Centers for Disease Control and Prevention.

The B.C. Centre for Disease Control tracks child immunization and reports that 82.1 per cent of children aged seven had been immunized for measles in 2018, compared to 88.4 per cent in 2017 and 90.2 per cent in 2016.

Across Canada, only a single new case of laboratory-confirmed measles was reported between Dec. 30, 2018, and Jan. 26, 2019, according to Health Canada’s most recent measles and rubella monitoring reports.

The agency said there have been large measles outbreaks reported across Europe which have affected many countries.

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9Feb

Measles case confirmed in Vancouver, not linked to Washington outbreak

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Reported cases of measles have spiked 30 per cent worldwide since 2016.


Jeff J Mitchell/Getty Images

Health authorities have confirmed a case of measles in Vancouver.

The patient, a Vancouver resident, was diagnosed on Thursday as having the virus, but the period during which it is considered infectious has since passed, said Shaf Hussain, a spokesman for Vancouver Coastal Health. The patient is receiving care.

The health authority last released a measles alert in September, when a person who was infected attended the Skookum Festival.

The latest case is not believed to be linked to an outbreak of measles in the state of Washington, Hussain said. A surge in measles cases prompted Gov. Jay Inslee to declare a state of emergency Jan. 25. As of Saturday, 54 cases had been confirmed. Health officials are urging residents to get immunized. Four more cases have been confirmed in Oregon.

Measles is highly infectious and spreads through air when an infected person coughs or sneezes, according to the Vancouver Coastal Health. Complications can include inflammation of the brain, convulsions, deafness, brain damage and death.

Infection does not require close contact and measles can survive in close areas, such as a bathroom, for up to two hours after an infected person has left. It causes fever, red eyes, cough, runny nose and a rash. Most people recover within a week or two.

Vancouver Coastal Health recommends vaccinations. People who have previously had the infection do not need immunization.

B.C. children born in or after 1994 routinely get two doses of the measles, mumps and rubella (MMR) vaccine, one dose when they turn a year old and another before they start kindergarten.

People born before 1994 or who grew up outside of B.C. may need a second dose. People born before 1970 are likely immune; but if they aren’t sure whether they have had the infection, they can safely get the MMR vaccine.

The B.C. Centre for Disease Control tracks child immunization and reports that 82.1 per cent of children aged seven had been immunized for measles in 2018, compared to 88.4 per cent in 2017 and 90.2 per cent in 2016.

Across Canada, only a single new case of laboratory-confirmed measles was reported between Dec. 30, 2018, and Jan. 26, 2019, according to Health Canada’s most recent measles and rubella monitoring reports.

The agency said there have been large measles outbreaks reported across Europe which have affected many countries.

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twitter.com/nickeagland




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31Jan

Chief medical health officer shares plan to stop Vancouver drug deaths

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Judy Darcy, B.C.’s minister of mental health and addictions (left), with Dr. Patricia Daly, the chief medical health officer at Vancouver Coastal Health, at the Lookout Housing and Health Society facility on Powell Street in Vancouver.


Jason Payne / PNG

Vancouver Coastal Health’s chief medical officer is urging health authorities to make it easier for people to start and stay on treatments for addictions as a way to spare lives during B.C.’s continuing overdose crisis.

Dr. Patricia Daly presented an update on the crisis at a public board meeting Wednesday that included four recommendations. She wants the health authority to implement treatment standards and monitor outcomes for patients’ addictions care, expand access to “opioid-agonist therapies” such as Suboxone and methadone, establish a safe and regulated supply of drugs, and expand addiction-prevention programs.

Daly’s first recommendation is to ensure that people who begin treatments for opioid addiction don’t slip through the cracks over time. She said residential treatment centres should have a standard of care and keep track of patients’ treatments.

“When we start people on treatment for their opioid addiction, they’re not retained on treatment in the long-term. So we need to have a system that will really track people over the long-term, including when they go into detox and recovery,” Daly told Postmedia. “There are people who are dying who just left detox and recovery because they’re not put on opioid-agonist therapy or being maintained on it.”

Daly wants it to be easier for people to access treatment in the first place. Many aren’t wiling to go to visit a clinic to begin opioid-agonist therapies, so the health authority needs to consider dispensing such treatments from emergency departments, and working with pharmacists to make it easier for people to access methadone, including at multiple pharmacies, Daly said.

People who are subsequently hospitalized or jailed must not miss doses of those treatments and risk relapse, she added.

Despite the expansion of harm-reduction measures such as naloxone and overdose-prevention sites, people are still dying from a fentanyl-poisoned street drug supply, which is why Daly is recommending a safer supply for people when other treatments fail.

Made with Flourish

She pointed to four sites offering injectable therapies, including a pilot program run by Dr. Christy Sutherland of the Portland Hotel Society which has started more than 300 people on injectable hydromorphone since 2016, and which in January introduced a tablet version of the drug for 50 new participants to crush and inject under observation.

The B.C. Centre for Disease Control has been planning for a similar pilot program that allows participants to take the pills with them, which Daly said is important for people who struggle to make multiple daily visits for supervised injection.

“I think we have to acknowledge that we’re in this crisis because of what’s happened to the illegal drug supply, and people are going to consume illegal substances,” she said. “We have to do everything we can to reduce the risk of people developing substance-use disorder, providing evidence-based treatments.”

Ensuring access to stimulants should be a next step, Daly added.

According to her report, 39 per cent of people who died of an overdose in Vancouver in 2017 used opioids daily, but another 19 per cent drank alcohol daily, 12 per cent used stimulants daily, and 18 per cent used both alcohol and stimulants daily.

Finally, Daly wants to see expanded addiction-prevention programs for youth, people living with chronic pain and First Nations people, who are five times more likely than non-First Nations people to experience an overdose, and three times more likely to die.

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