Front Burner - Canada has a measles problem

Episode Date: May 16, 2025

Measles case numbers in Ontario are now higher than the total registered cases in the entire United States.This week’s report from Ontario Public Health puts the total at 1,646 cases of the disease since January. In Alberta, measles is spreading even quicker, outpacing Ontario in growth per-capita. Nearly three decades ago Canada had declared measles completely eliminated. But now the country is facing a situation where public health experts say, without prompt action, the disease could become endemic once again.CBC senior health reporter, Jennifer Yoon, joins the show to talk about how things got so bad and what public health officials are doing about it.For transcripts of Front Burner, please visit: https://www.cbc.ca/radio/frontburner/transcripts

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Hi everyone, I'm Jamie Poisson. There's been so much going on in the news that an alarming statistic might have escaped your attention. Measles case numbers in Ontario are higher than the total registered cases of the entire United States. As of today, it is 1,646 cases since January. In Alberta, measles is spreading even quicker, outpacing Ontario in growth per capita. In 1998, Canada declared measles completely eliminated. But we are now facing a situation where public health experts think that if we do not turn

things around in the next five or six months, the disease could become endemic once again. Today I'm joined by CBC senior health reporter Jennifer Yoon to talk about how Canada's measles numbers got so out of control. Whether provincial health authorities are taking enough action and how people with small babies should be thinking about protecting them. about protecting them. Jennifer, thank you so much for doing this with me today. Thanks for having me. So listen, my first question is this. Are Ontario's measles numbers seriously higher

than the entire United States? Is that possibly correct? That is correct. Right now, Ontario alone has more cases than the entire US combined. Wow. There is some possibility that the US is undercounting. In fact, in April, one senior scientist at the US Centers for Disease Control told American networks that they're probably undercounting. But that's true generally with measles because of how contagious that is. We're going to assume that there's more cases in the communities than what's being picked up by public health officials.

All that doesn't take away from the fact Ontario, the situation is bad. The situation is getting bad in Alberta, and there are cases popping up in other provinces as well. Just sticking with Ontario here, what do we know about how this outbreak started and spread? We know that it really started in October. So there was a wedding, a Mennonite wedding in New Brunswick.

Somebody went to the wedding and then came back to Ontario and they started spreading measles. Public health officials said they never really got it under control and the cases that we're seeing right now are by and large connected with that outbreak. Not all, but most of them are. I wanna be careful here about not blaming or unfairly singling out Mennonite communities because of course we know that there are cases not in Mennonite communities.

But we do know also that many of the outbreaks in the US as well have been in Mennonite and other Anabaptist communities and what do we know about why that is? So what you said there about stigma is absolutely what public health officials are thinking about. We know for sure that these are communities that have historic objections for vaccinations for generations. Public health officials have said that they have religious objections, they have historically low vaccination rates, but some of them have not said that these are Mennonite communities. Ontario's top doctor, Kieran Moore, did come out at the beginning and said that these are Mennonite communities, but it doesn't really matter if you're Mennonite or not. If you're unvaccinated, you're not

protected. So that's the kind of messaging that public health has been trying to give. It might be worth noting here, I remember in 2021 Mennonite Church Canada said that they would not be providing religious exemptions from the COVID-19 vaccine because there's nothing in the Bible, quote, in our historic confessions of faith, in our theology, or in our ecclesiology that justifies granting a religious exemption from vaccinations against COVID-19. Has a church said anything about measles, about the MMR vaccine? So it's tough because Mennonites are a really diverse group, right? Anabaptist communities are really diverse.

And I think that's the tricky thing. There's some messaging that public health is trying to translate into low German, which is a language being spoken in many of these communities, whether that's being picked up and adopted and really taken to heart. That's less clear because it's also a pretty closed community. Just to be clear about where these outbreaks are at the moment, is it fair for me to say that in Toronto and Ottawa, we don't seem to be seeing the same kind of outbreaks? One of the key indicators that we're seeing that it's not that serious in Toronto or in

you know urban cities is that they're having exposures. For example at Ripley's Aquarium across the street from where we are right now at the CBC there was an exposure there and if the the situation with vaccination rates were lower or if you got unlucky and there were exposures there we would be seeing seeing more spillovers but we are not. Right. Because a lot of the people that were there that day were probably vaccinated. Yeah. I know that there have been other provinces where there have been outbreaks, but those outbreaks have fizzled, like in Quebec, for example. And just, I wonder if you could like compare what's happening in

Ontario to what's happening in Quebec for me. Yeah. The story started similarly in Quebec. It wasn't a wedding, it was a business conference, and somebody went to the conference, went home, and then started spreading measles in their community. It's Laurentians, which is north of Montreal. But when we asked the regional public health officials about what happened there that's different from what happened in Ontario, they said that they got lucky essentially. One metaphor that I think is helpful is a wildfire. That's something that we've

heard a lot. Imagine all those sparks and embers flying from a wildfire and if it lands in a pond or a lake, you're good, right? But if it lands in a dry spot in a bunch of kindling or in dry leaves, it catches fire and spreads and more embers start flying. That is essentially what is happening in Ontario and that's essentially what didn't happen in Quebec and that's what allowed that province to get their outbreak under control. Public health officials say that an outbreak is over

if there's been no transmissions for 32 days and that's essentially how Quebec got it under control. It is interesting, we've seen these outbreaks in Ontario for example, though unlike what we've seen in Texas, we haven't seen deaths from measles here this year. There was a child who died last year really tragically. How could that be when the numbers here are so much higher? Statistically, we're there. Statistically, we're at a point where we should be unfortunately expecting a death. And this is a conversation that public health officials are having at a high level.

I talked to the head of the infectious diseases division at the Children's Hospital in London, which sees the most severe cases in Ontario right now. And she said that there might be luck involved. That is one part of it. Another part is heroic efforts of healthcare workers. They're learning as they go and they're getting better at treating these kids as

they go. Another factor could be that public health authorities are doing a good job of signaling to families, maybe even if it's too late for them to get vaccinated, Hey, here are the signs that you should look for. Here is when you need to bring your kids to hospital so they're not in a worse state and, and

doctors can do more for them once they are in the hospital. But she told me that there is a possibility that that can happen after measles and we just have missed them. So a child might have had measles and recovered, but because their immune system gets hit pretty hard by this virus, what can happen is that they might show up in hospital a while later with, say, a bacterial infection, for example. And the parents might not tell the doctors, this kid had a measles infection. And for the doctor at the Children's Hospital in London,

she would count that as a measles death, but it would not go reported as a measles death. Gotcha. Yeah. I want to get into those impacts with you a little bit more in a few minutes. Let's talk about Alberta first though. In some ways, it's even more alarming than Ontario. And what are we seeing there? In Alberta, what we're seeing is the numbers themselves look like what Ontario's numbers look like at the beginning of the outbreak. So you're seeing increases. Alberta updates their numbers daily, not weekly like

Ontario's. So it's a bit different to different numbers that you're playing with, but you are seeing a growth. And keep in mind Alberta's population is less than half of Ontario's and seeing those numbers, that is really not a good sign. Another thing that is quite concerning about Alberta, particularly our vaccination rates in some communities, and I just want to read you some in 40 mile in Alberta, it's the vaccination rate for seven year olds who have two doses of the measles, mumps and rubella vaccine, 30.2% to hills 24% T, 39.1 percent. Those are very dismal numbers and concerning numbers when infectious diseases experts are

trying to contain the spread. And similar to Ontario, these outbreaks have mainly been in rural areas, right? Especially areas with large Anabaptist religious communities, if I'm not mistaken. Yeah, there are having cases, for example, in Tabor, which has a significant Mennonite population, for instance. But the thing is, like I said earlier, it doesn't really matter what religion you are. If you are unvaccinated, if you are not protected against the virus, then you are at higher risk. And one thing that public health authorities in Alberta have told me about is the spread of misinformation and the kind of information parents are getting, not just in these religious

communities, but in the wider community and why they might be hesitant to get the jab and what that's going to look like once it starts spreading more widely. Okay, Gav, what is the hardest thing about doing a news quiz right now in 2025? Donald Trump. The hardest thing is that we've had to rewrite the script, what, four times today because he changes his mind literally every hour. Yeah, the tariffs are off, the tariffs are on. But I mean, the good thing is on our quiz show, it doesn't really matter if people give the right answer, because it's more fun when they give the wrong answer.

This is true. And guaranteed, if Trump's in the office, there'll be a lot of wrong answers. Ah, Spotify, follow us every Friday. New app. It's because news. Related to that, we know that broad vaccine hesitancy, including about the MMR vaccine, has increased since the pandemic. That's obviously a factor here.

We've also seen some very influential voices on this, it's worth mentioning, including United States Health Secretary Robert F. Kennedy Jr., claiming that you can't die from measles if you're healthy and eating well and that the kids who have died from it in the U.S. didn't have good nutrition. That is absolutely not true. And so just give us a rundown of who is in fact at risk of dying from measles and what other kinds of risks this virus carries. Let's get into that. Healthy kids can die of measles. This is something that is a fact. Measles is interesting because it kind of replicates itself and goes bananas all over your body. So what that looks like, one in ten people who get

measles, healthy kids who get measles, will get a severe ear infection. One in ten will also get pneumonia, and that is one of the ways that measles can most easily kill you. One in one thousand can get encephalitis, that is brain inflammation. Your brain swells up and that can be fatal. And that can also have long-term impacts down the line. I spoke with this woman in the United States who got measles back in the 60s. She was six years old and she was obviously not able to have the vaccine because it wasn't around at that point.

And she got encephalitis and she lost her ability to move her legs and then her arms. And then she fell into a coma for 30 days. She says that she remembers how helpless she felt. And when she did wake up, doctors told her that you would never walk again. And she spent hours, days, months dragging herself on her arms trying to learn how to walk again and she was successful. But she's still all those years later, all these years later, she still has impacts. She still suffers from muscle weakness. She has memory issues and her neurologist says that's probably linked to encephalitis. Encephalitis can also

lead to loss of hearing and blindness as well. I know you reported on an incredibly tragic story of a young girl who got measles as a baby, recovered and then actually ended up dying from it. recovered and then actually ended up dying from it a decade later. And just could you briefly tell me that story? Yeah. This woman I spoke with, her daughter Renee was five months old when she got measles. She was too little to get vaccinated. You can start getting vaccinated 12 months is recommendation, but six months in situations where there are outbreaks. There was an outbreak in Manchester, UK, where the family lives. And the baby had pretty severe reactions, had to go to the hospital, needed help breathing.

But then she seemed to get better and there seemed to be no other health complications. Completely healthy baby otherwise, grew up to be 10 years old. And the family had forgotten about it, not thought much about measles. And then the mom gets a call from the school saying, hey, your kid is having a seizure. And so she picks her up, brings her to the hospital, doctors are trying all kinds of things, wondering what's wrong with her, thinking it's epilepsy, nothing is working. And it turned out to be the measles virus. It had stayed in her brain dormant, sleeping for 10 years, and it woke up.

And when it did, there was nothing the family could do. They told me that it was gonna be fatal, and she'd have no brain activity. It was degenerative. She lost her ability to speak, to eat, move her body. And then ultimately the family had to decide when she would get off life support. Wow. It's incredibly serious disease. Probably worth mentioning again here that in 1998, Canada had declared it eliminated. Jennifer,

these like secondary issues and infections that you're describing, am I right to say that at least part of the reason why they occur is because the measles like essentially wipes out your immune system? Yeah, that is one of the things that measles can do. It's called immune amnesia and measles can trigger that where your body forgets every virus it's ever fought up against and has the battle plans for, your body kind of knows how to fight viruses that could be all gone. And that's the thing, we talk about hospitalizations, we talk about deaths, but measles can do so much that can really impact a child's life forever, like for their entire life. And one immunologist I was talking to was talking about how, you know, we try to count it through death,

but think about all the lost human potential, all the memory loss, all the not full lives lived because of the consequences of getting this disease that we got rid of. And one of the most terrifying things about it is that it can stay in the air after an infected person leaves the room for up to, I think it's two hours, right? Yeah, that's right. And measles, I can't stress this enough, is one of the most contagious viruses known to humankind. So one person can infect between 12 to 18 people. And that's the tricky thing for public health officials to try and contain. That's why when you look at those exposure notices, when public health says there was a case, there was an exposure at this grocery store from like 12 32 to 1 30, the reason why they're so precise

is because of how contagious it is, because of how resilient it is in the air, and because of how devastating it can be for those who aren't protected. [♪ Music playing. I want to get into the public health response with you more now, especially in Ontario and Alberta. Let's do Ontario first. If we look back at the COVID-19 pandemic, Ontario's chief medical officer of health and typically Premier Doug Ford as well,

were doing these weekly press conferences about COVID to keep the public informed about it. And how does that compare to what they're doing now? It's been the polar opposite. They're not doing that at all. They're not doing press conferences on a weekly basis. They're releasing data, pretty detailed data every week. But other than that, when you look at the public health, like the whole coming up and doing interviews even, Dr. Kira Moore, we tried to book interviews with him several

times before he finally said yes. So it's been difficult to pin down the top public health officials in Ontario on the subject. Have they talked about why they're they're not doing that? When I asked this to Dr. Moore point-blank he said because the vast majority of Ontario is safe, protected and have had great uptake for measles vaccine I don't want to instill fear. Some people see me and have reflections on COVID and pandemic, et cetera.

I want to assure Ontarians that we remain protected. Ontario is one of only three provinces that requires a measles vaccination to attend school. But actually it's pretty simple to get an exemption. I think you basically just have to like watch a video and fill out a form. That's right. So there have been calls for the province to get rid of those exemptions, to make vaccines a requirement to go to school.

And what has Kieran Moore said about that? Kieran Moore said that we still have to respect autonomy of individuals. He said that we're not doing that because We have to respect the decision of families when they opt out, but the vast majority of Ontarians have realized the benefit of prevention through immunization, especially for measles, mumps and rubella. So he's trying to strike this balance between saying it's an individual choice, but also at the same time, it's important to get vaccinated, which is a tough line at some point to walk.

Yeah. Our producer, Ali, spoke earlier this week with Andre Picard, the Globe and Mail's health columnist, who I know you know. He wrote a piece recently that was very critical of the Ontario government's response to the measles outbreak. Well, I think the communication is terrible. You know, that I don't think it's being taken seriously. This is the biggest outbreak in three decades. This is a really big deal. He feels really strongly that all provinces should have laws saying that you have to be vaccinated

to go to school. Well, we know that schools are going to be a major source of outbreaks. That's where kids congregate. So I think it'd be very difficult to control outbreaks and to prevent future ones, unless we have a, you know, this herd immunity in schools. And he's been very critical of what Dr. Kieran Moore has been saying, defending the province's religious and philosophical exemption, saying that, uh, we have to respect people's opinions on this, uh, that we have to use carrots and not sticks as, as you just explained. As far as I know, I don't, there's no mainstream religion that's opposed to vaccination in any way,

shape or form. There's a few very small marginal religions like Christian science that is opposed to vaccination, but even they make exceptions. So I think the religious one goes out the window. So I don't know why that's in the law. What's a philosophical objection to vaccination? I think that's an important question. I know what philosophical exemptions are. I don't believe we should kill animals. I believe they're equal to people. Therefore, I don't eat meat. That's a philosophical objection. What's the philosophical objection to vaccines? Is it that I want kids to get sick and die? I don't want to be flippant about this, but I don't know what the objection really is. So it's just become a catch-all. I don't like it.

Well, I don't like it is not a good reason to not obey the law. I don't like stop signs. I don't like seat belts. I don't like that I can't beat my children. There's all kinds of things that we prevent parents from doing for the greater good and for the good of their children. And I think this is an example. Have Kieran Moore or Doug Ford responded to any of these kind of arguments that they're letting people's personal opinions outweigh the greater good and that that is causing serious harm? Well, again, I think Moore goes back to this word that he used really sticks with me. He says, we still have to respect autonomy of individuals, individual choice, but without having to be too draconian, we've achieved what we need to keep our schools safe.

They can't impose this on people. And so I think they're thinking about that calculus. Doug Ford put it even more bluntly, shall we say, when he said that, yeah, vaccines are a no-brainer, people should be getting them, but... You don't think it should be mandatory? How do you, it's a good point, but how do you force someone? Do you grab their kid and start jabbing them with a needle? It's a problem. I agree. But we're throwing everything in the... So this is a calculus that politicians are having to make right now, but how far they're going to push this? Right. Because I guess, to be fair, the counter- counter argument here is that if you push too hard, you could potentially cause an even greater anti-vax backlash.

What about Alberta? I know the chief medical officer whose contract ended recently has spoken about the measles outbreak, but only after he left his position. And just tell me more about that. So Alberta's doctor, Mark Joffe, was pretty quiet about the measles outbreak in the province until he his contract ended as a top doctor a couple of weeks ago, at which point he called the outbreaks a quote, complete failure of leadership at all levels. And he did the sum in a medical grand rounds at a university. That's when doctors present a

case or a medical problem to other doctors and residents and student doctors for educational purposes. And I think we're seeing the fallout of COVID-19, the response of COVID-19 and how to respond to public health crises in a world in which people have become tired of vaccines to a certain extent. People have lived through this intense period of public health messaging. And Saskatchewan's top doctor, he put it so clearly when he said, the social contract is broken, that we as a society can't be depended on to vaccinate ourselves and our kids to reach herd immunity, that's the rate at which we have protected the most vulnerable among us and stop the spread of diseases that we were able to

stop in the past. Just to be frank, for the governments in either Ontario or Alberta, I imagine that there is also political calculations at play here, right? Especially maybe for Premier Daniel Smith in Alberta, it's obviously not in her political brand to make vaccinations a requirement for going to school, for example. I mean, everything that a government does expends political capital, right? And this would be one of the things. And some think, yes, these top doctors could be getting muzzled. The one person I spoke to who said that was Dr. Michael Gordon,

who used to run Health P.E.I. Provincial public health is very much under the umbrella of government, right? It's very much under the umbrella of politicians. I have no doubt whatsoever what public health in Ontario and Alberta think about vaccination. I know they're incredibly pro-vaccine, etc., but the fact that they're not able to message this, that doesn't surprise me at all. I would argue these positions are meant to be protectors of the public, they're not meant to be protectors of politicians. And unfortunately, that's what they've become. [♪ MUSIC PLAYING FADES IN, FADES OUT, MUSIC FADES IN, FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES OUT, MUSIC FADES out, MUSIC FADES out, MUSIC FADES out, MUSIC FADES out, MUSIC FADES out, MUSIC FADES out, MUSIC FADES out, MUSIC FADES out, MUSIC FADES out, MUSIC FADES out, MUSIC FADES out, MUSIC public health authorities are doing in some of these communities, rural communities, religious communities. I know you alluded to it earlier, what Alberta is doing, for example, to increase measles vaccination in Ontario too. What are they doing to try and build that trust and get people vaccinated?

Well, one thing is they're just making vaccines more available. I went and visited a community hockey rink a couple of weeks ago in southwestern Ontario in one of the areas where there was a measles outbreak and they're really trying to get people to get vaccinated, making it accessible in front of them. Another thing that they're doing is trying to talk to community leaders because they know that these are the people who are going to be hugely influential in the communities where measles is hitting them the hardest. So Dr. Keeamore told me that he is in contact with them. That is in and of itself he's taking as a win,

that they're not scared to come to hospitals and ask for help. He also told me that in some communities like north of Belleville, they were able to convince some faith leaders to get their community vaccinated. So some indication that that is working. But to what extent? Well, you just need to look at the case numbers and look at how they continue to climb to know that there is a limit to that effort and how much it's working. Yeah. Yeah. I know there was an interesting example out of New York, I believe, like an Orthodox Jewish community there in New York. Health authorities got through the rabbis and did get the rabbis to encourage vaccination. So it's a tool for sure. Just lastly, MMR vaccines are, as you mentioned,

normally given starting at a year old. And I think you said that now they're being offered for children as young as six months in certain cases when there are measles outbreaks. But what about parents of babies under six months? Like this is a virus that can linger in the air for two hours and this is a country that is freezing cold half the year. And not to be alarmist, but can parents of little babies

safely take them anywhere indoors, realistically? So the risk level is not zero. Unfortunately, when you're taking a kid that's too young to be vaccinated to different areas indoors, one of the things that you can do as a parent to try and protect them is get vaccinated, because that means not only are you immune, you are not going to pass on the virus to your little one. You can also, you know, check immunization status before you invite someone over. Just make sure, have you gotten two doses of the

MMR? Unfortunately, you know, other than that, though, if you're in those areas where there's an outbreak, there is a risk that you're taking when you're taking your kid out. But also, I will say this, think about where you are and look around, see what the outbreak situation is like. Think about that before you start panicking too much about whether your kid's going to be exposed or not because your risk level is going to change dramatically depending on what's around you. Okay. Jennifer, this was really helpful. Thank you so much for doing this today. You're welcome. All right, that is all for today. Front Burner was produced this week by Matthew Amha,

Ali Janes, Joy the Shangupta, Lauren Donnelly, and Mackenzie Cameron. Our intern is Katie Teeling. Our video producer is Evan Agard, and our YouTube producer is John Lee. Our music is by Joseph Shabason. Our senior producer is Elaine Chao. Our executive producer is Nick Bacay-Blocos, and I'm Jamie Poisson.

Thanks so much for listening, and talk to you next week.