Measles Outbreak Threatens Canada’s Health Status

Outside the emergency room at St. Thomas Elgin General Hospital, located about 200 kilometers southwest of Toronto, a bright yellow sign sends a stark message: “NO MEASLES VAX & FEVER COUGH RASH – STOP – DO NOT ENTER!” It’s a striking sight, particularly in a country like Canada that had, until recently, managed to achieve “elimination status” for measles back in 1998, meaning the virus was not regularly spreading.

But the situation has taken a turn, placing Canada at risk of losing that hard-earned status. The root of the issue is a significant outbreak of measles in southwestern Ontario, where the St. Thomas hospital is situated.

Since October, the province has reported an astonishing 2,009 measles cases connected to this outbreak—more than the total cases in the United States for the entirety of 2025, making Ontario the hotbed for measles in the western hemisphere.

Recent numbers show cases rising rapidly, with three-quarters of those afflicted being unvaccinated children, according to Public Health Ontario. Unfortunately, this week, the first death linked to the outbreak was reported— a premature infant who contracted the infection in utero from their unvaccinated mother. Although Ontario’s chief medical officer, Kieran Moore, noted that the baby faced other unrelated health complications, measles may have played a role in both the premature birth and subsequent passing.

Asmaa Hussain, the head of pediatrics at St. Thomas Elgin General, remarked on the unprecedented nature of this outbreak. “I’ve been practicing for quite some time, and we haven’t seen such a significant outbreak in our community,” she noted. Many doctors, she pointed out, have never even treated a case of measles until now.

Hussain suspects the real number of cases could be much higher. “Many families are likely staying at home with measles without ever visiting the hospital,” she observed. “The confirmed cases only scratch the surface of what is happening in our community.”

Almost 40% of the reported cases in Ontario have come from the Southwestern Public Health Unit, which serves areas like Oxford and Elgin counties and St. Thomas, about a two-hour drive from Toronto.

While the extent of this outbreak is alarming, healthcare professionals and public health experts argue that the resurgence of measles was, to some extent, expected. A mix of outdated local vaccination strategies, limited access to family doctors, delays in routine immunizations due to the COVID-19 pandemic, and an increase in vaccine hesitancy fueled by online misinformation have all contributed to the current crisis.

Moreover, southwestern Ontario is home to several close-knit religious communities, including Mennonites, who may be less exposed to public health messaging. The outbreak has even been traced back to a Mennonite wedding in New Brunswick, where a guest carried the virus back to Ontario.

Case numbers are also rising in Alberta, which recently reported a total of 710 confirmed measles cases this year—the worst since 1986.

Measles is characterized by several symptoms: fever, cough, and a widespread rash that can lead to severe complications, including brain damage and death. Thankfully, it is easily preventable with a vaccine. Canada aims for 95% immunization coverage to prevent outbreaks.

However, first-dose vaccination coverage has dropped from 90% in 2019 to 83% in 2023, according to the Public Health Agency of Canada. In St. Thomas, Hussain has seen many infants under 12 months with measles. Infants younger than a year can’t receive the vaccine, and many cases involve older siblings who contract the virus at school.

Additionally, Hussain treated an unvaccinated woman who caught measles from her children before passing it to her newborn. Although Ontario law prohibits unvaccinated children from attending school unless exempt for valid medical reasons or personal beliefs, these exceptions do exist.

When unvaccinated families come to healthcare facilities with measles, Hussain finds it challenging to engage parents about vaccination. “It’s tough to even start that conversation,” she admits. Responses often include claims of exemption or a simple refusal to engage further.

Dawn Bowdish, an immunologist and professor at McMaster University, pointed out that rising distrust of vaccines has compounded this issue. She highlighted the shortage of family doctors—20% of Canadians lack a regular physician—making it hard for parents to discuss vaccines with a trusted healthcare provider. The absence of a national vaccine registry also complicates matters, as checking one’s vaccination status can be difficult.

Bowdish warned that vaccine exemptions are too easily granted now. “People might not have a solid reason tied to their beliefs but just a general reluctance to vaccinate,” she said. It creates a tough balance between personal freedoms and public health.

The Ontario Ministry of Health didn’t respond to inquiries regarding vaccine exemptions or strategies targeting specific communities. Vaccine clinics have been established across southwestern Ontario to increase measles immunization rates, but they haven’t taken place in schools. The government has mentioned ongoing collaboration with local health units to address vaccine hesitancy, but the challenge remains daunting.

Kumanan Wilson, a doctor and professor at the University of Ottawa, asserted that the pandemic heightened anxieties around government control, leading to fewer people having regular access to medical care. He warned that focusing solely on religious communities might distract from the underlying issues that have weakened public health initiatives.

Wilson underscored the need for effective communication strategies, especially in a time when trust in government may be waning. “Finding credible voices within communities who can convey public health messages is essential,” he noted. Previous strategies—like shaming those who don’t vaccinate—are simply ineffective now.

A recent study suggested that about 25% of Canadians doubt their provincial governments’ ability to handle the measles outbreak adequately, with Ontario’s figures rising to 27%. Moreover, one in five Canadians with children under 18 are hesitant about vaccinations.

Hussain expressed concern that other diseases long considered dormant could resurface. While measles can often be managed by dedicated physicians, conditions like polio could present far more serious threats. “I fear the next outbreak is already on the horizon,” she said, echoing a sentiment that many share.