The Decibel - Tracing the virus: How measles made its way back to Canada

Episode Date: September 24, 2025

Measles is one of the most contagious respiratory viruses in the world. But for decades, it rarely infected Canadians. That’s not true any more. Since October, 2024, North America has seen record case numbers — and most of them seem to lead back to one Canadian family.Today, The Globe’s international correspondent Nathan Vanderklippe joins the show. He’ll tell us the story of his 40,000-kilometre journey to trace the measles outbreak and to figure out how it took hold in North America after Canada eliminated it 27 years ago. He’ll explain why this spread has been so hard to contain and what tracing its spread can teach us about preventing and preparing for future outbreaks.Questions? Comments? Ideas? Email us at [e-mail] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

On October 18th, 2024, Charity and Josiah Dredger got married in Florenceville, New Brunswick. Charity is the youngest of nine. She was getting married. It was the first time the entire family had been together after COVID. Nathan Vanderclip, the Globe's international correspondent, spoke with Charity. There had been a number of weddings in the family, as you would expect with nine siblings. and a number of those weddings had had issues. It felt like there was this sort of family wedding curse. And so they get right up to the moment that the ceremony is supposed to start. The photographer is still not there.

And so they're like, well, I guess this is our wedding disaster. It happened to us as well. But that was not their wedding disaster. It was something much worse. Leah is one of the sisters. Leah has been living in Asia for more than a decade, currently living in southern Thailand with her family. Leah flew in from Thailand for the wedding,

but along the way, she started getting sick. The night before the wedding, she's not feeling well. She has a fever, her throat was in pain, but she takes an Advil, and she says, you know, I'm going to get through this. But hours after the wedding, Leah's symptoms got worse, and she decided to go to the nearest hospital. She stayed for a couple of days and was sent home with antibiotics. But she's feeling worse and worse.

Her family members are like, listen, I think you need to go back in. She gets a CT scan that shows some pneumonia in one of her lungs. The doctors tell her your liver's not working right. And then at one point they also tell her that she appears to be going into septic shock. She said, I didn't know if I would be able to come out of it. Five days after the wedding, once everyone had traveled back home, the hospital confirmed that Leah had measles. Measles is known for its tell-tale blotchy red rash, fever, and cough.

In some cases, it can be fatal. Leah luckily recovered, but it's believed that her case of measles began the largest outbreak in Canada since the country eliminated the disease 27 years ago. Nathan traveled 40,000 kilometers to find out how measles took cold, not only in Canada, but across many parts of North America. He'll tell us why it's been so hard to contain and what tracing the spread can teach us about preventing or preparing for future outbreaks. I'm Cheryl Sutherland, and this is the decibel from the Globe and Mail. So Nathan, you traveled over 40,000 kilometers to get to the bottom of how this measles outbreak started.

Can you just tell me, like, why is it important that we pay attention to how this has spread? I think it's important for a number of reasons. reasons. One, we are now seeing the recurrence of diseases that we thought we had gotten under control through vaccines, both in Canada and around the world. There's a lot of folks in public health who will tell you the measles is the canary in the coal mine that it means that we are likely to see other diseases spread as well. So there's that. It's an important moment potentially for Canada in public health. Canada eliminated the measles in 1998. If the current trends continue over the next few weeks, Canada's likely to lose that elimination status. And that will mean the

loss of something that had been considered quite a considerable public health victory. But I think also we are at a moment where something's changing. Something is changing in the way many people think about authority, about the way many people think about the sorts of things that government suggests they do. And I think this is true not only in politics, but in medicine. And measles is part of that. And I think tracking the way the measles has moved tells us a little bit not just about disease, but also about the moment we're living in. And then beyond that, I just think it's interesting. How did this happen? The measles is back. And how? I'm curious about like you're reporting here because 40,000 kilometers is a long way to go to tell one story. Why did you want to do this?

What was it for you? We have had the measles that has spread through the Americas. If you look over the last 12 months, it's been in Canada, it's been in the United States, it's been in Mexico, but it's been all up and down the Americas, down deep into South America. And of course, we've had cases in Europe as well. But this has been a reasonably considerable outbreak. But what's interesting about it is that Canada's played a really central role. Of all the cases in the Americas, Canada counts nearly half of them. And it appears that a decent percentage of those cases started from Canada. So Canada's played kind of a central role in this return of the measles, as we've seen it in the last year.

Let's go back to October 2024 to the aftermath of this wedding in New Brunswick. So once it's confirmed that Leah has measles, what happens? Like, where does it begin to spread? So the wedding is on October 18. And after the wedding, of course, people start to go back home. There are something like 167 guests at the wedding. More than 100 of them are from Ontario. And then the first confirmed case in Ontario emerges on October.

And by the end of 2024, we have cases in a half. a half dozen provinces. In Quebec, they start reporting cases in December. And from there, it goes down into the United States. And just to be clear, so this spread is started by these wedding guests who got it from Leah? So what we know is that of the wedding guests who were not vaccinated, what the family says is all of them got the measles. Wow. Many of those people went to Ontario. So you had people who were exposed at the wedding and then traveled back to Ontario and had the measles with them. And we also know from the public health authorities in Ontario that they said that those were all related to this importation of the measles

by an international traveler into New Brunswick. Canadian public health authorities have said that something like 98% of the cases that they have tabulated in Canada were related to this one case. You know, measles comes in all sorts of different ways because people travel from other parts of the world that have the measles. But in this case, this one particular strain that came into Canada in October 2020, to New Brunswick, has been prolific. That's so fascinating that they can track it right down to this one particular celebration. And I think it's a good point to kind of remind people how contagious measles is.

Because you said that everyone at the wedding who was not vaccinated got the measles. Can you just explain just how contagious measles is? Well, do you remember during COVID? we started using this term are not and we all considered ourselves sort of amateur epidemiologists and it's sort of a measure of how quickly a disease can spread

and you can look at a bunch of different diseases that we consider to be relatively contagious none of them hold a candle to the measles so you know one person who has the measles can affect 12 to 18 other people the virus can hang literally suspended in the air for up to

two hours. And then somebody else can come in when you're not even in the room anymore and breathe that and contract the measles. And it's also one of these things where it for people who are not vaccinated, the likelihood of being infected by exposure is incredibly high. Something like 90% of unvaccinated people who are exposed to someone who is infectious with the measles will then themselves contract the measles. So it's just an extraordinarily contagious virus. Wow. Wow, yeah. So what's the reaction by these provinces as they start to see cases rise? Well, we see it first in New Brunswick and we see an immediate response where public health authorities immediately respond with a couple of pop-up clinics coming out, offering vaccinations in some of the areas where people had been exposed at first. And then we see the same thing in Ontario and in other areas of Canada. One of the fascinating things about the measles is that if you know you have been exposed but aren't.

not vaccinated, you can get vaccinated within the first 24 to 48 hours of your exposure and that vaccine can still protect you from contracting the measles in the same way. So there's value in getting vaccines out in a hurry, which is what they sought to do. Okay. And so we know that Leah got measles from Thailand where she lived. Can you explain because you went to Thailand? What's going on with the measles there? Right. So Thailand is one of these parts of the world that thought that they were going to eliminate the measles by now, actually. They had a goal of eliminating it by 2023. And then COVID hit. And of course, everything got turned upside down in a whole bunch of different ways. One, we were obviously fighting a different virus and, you know,

a lot of existing programs for other things got waylaid. Two, everything that happened around vaccines during COVID affected people's willingness to take vaccines for other sicknesses, measles included. And when I spoke with people in public health, epidemiologists in Thailand, they now say most of Thailand actually might be able to achieve elimination of the measles. But southern Thailand, which is the place I went to, which is the place Leah and her family live, is unlikely to achieve elimination anytime soon. It might be a decade. It might be two decades. It might take generational change. Or perhaps, you know, we won't see it. Why is it that place, that part of Thailand will not be seeing an elimination? Well, we've seen a number of parts of the world and a number of communities that have been reluctant to vaccinate. And in southern Thailand, it's a Muslim population in a Buddhist country.

There is longstanding distrust. There has been violence. There's been extremism in that part of the country. And so that's kind of the backdrop. And there are other issues that we've also seen in other Muslim countries. there are fears that vaccines contain pork products and are therefore a violation of halal. Those fears have been debunked, including by Muslim authorities in Thailand itself. But, you know, suspicions have persisted.

And then there's an economic factor as well. Some of these Muslim areas are quite poor. And one of the things that children tend to get after getting the vaccine is a fever. And that fever can take a child out of. a school. If a child does out of school, the parents perhaps can't work. And that has an economic cost. And so there's an economic factor, too, that has made in some places people reluctant to have their children vaccinated. You know, the reluctance for vaccines and hesitancy. It's different in different parts of the world. But of course, we're seeing it in many different places,

including Thailand, including North America. So yeah, just interesting to see that. So you went to New Brunswick. You went to Thailand. And you also went to Texas where you spoke. to people about the outbreak there. What did you learn in Texas? Well, Texas was interesting because, I mean, we had considerable outbreaks in Canada before they had an outbreak in Texas. And in fact, if you look at the numbers of confirmed measles cases, both Ontario and Alberta, have had more cases than the entire case count in the United States combined. Nonetheless, what happened in Texas was their first confirmed case came within a week of the inauguration of Donald Trump. The inauguration

of Donald Trump has, of course, had all sorts of implications for public health. He has named a secretary of health and human services, who's been a vaccine skeptic. And so these measles cases erupted in Texas at a time of great political dislocation in the United States and how the federal government would respond in the case of a vaccine preventable disease returning. And here it was, Texas, no less, you know, a bastion of American conservatism. So what that meant was there was an enormous spotlight that was trained on Texas. And you had this new Secretary of Health and Human Services, RFK Jr., personally go down. You had a number of conspiracy theories that circulated.

There were people who were saying that they thought maybe these vaccines were somehow or some of the measles itself was somehow a target. how they targeted sickness against their population, the Mennonite population in this part of Texas. And I think even for Canadians, I imagine there were Canadians who perhaps weren't paying as much attention to what was happening in Ontario, who perhaps through CNN or others started to pay attention when it emerged in Texas.

So it was a big deal. And one of the questions that I had was, how did it get there? We'll be right back. You mentioned the Mennonite. community actually where there were big numbers in Texas. Can you just explain why and what you learned? Yeah. So the Mennonite community in Texas, in northwestern Texas, Gaines County, a place called Seminole, dates back to the 1970s. Many of the Mennonites who came there actually came from Canada. And this was a community that came to this part of Texas in hopes of finding there

the space to pursue its life, its language, its traditions, kind of on its own. So you have have different Mennonites communities that have their own schools, small little community schools, and you can go into restaurants where people are still speaking, this Plout Deutsch, this low German language. And it's kind of a remarkable community that's built up there. But it's also been a community that has had lower than average rates of vaccination. And of course, that that made it vulnerable when the muses began to spread. And many people in this area were also not going to doctors or hospitals, right? So do we know why? We do have a sense of why, and it's a few different things. One is, I think there was a sense that, hey, listen, our parents, our grandparents

dealt with this. It's just a virus. We can manage, you know, and they get through it. But there's also a sense that the hospitals and the formal medical establishment was mistreating people with measles. There was a feeling that people were being judged for not being vaccinated, and that was in part because with the immense amount of national attention that was paid to this. But also, my sense was that hospitals, of course, have to be very careful with these extraordinarily infectious diseases and how they treat patients as they come in onto the physical premises of the hospital. And so there was a sense that people who had the measles weren't welcome inside medical facilities to the degree that that's true or not true. I suppose that that was dependent on individual circumstances.

Certainly, you know, there were people who were given treatment in hospital. So there was a sense of both, you know, we can manage this on our own and maybe we're not terribly welcome in the hospital. So there was a desire to do what could be done at home. And so what were people doing about the spread other than going to the hospitals? I know there's someone named Nancy that gets involved here. Right. There's this really kind of neat health food store in Seminole, Texas, which is run by a woman named Nancy. Nancy, who has been selling health products since she was a teenager.

Now has quite a nice store there. And she's metadata. And people came to Nancy because they'd grown to trust Nancy. People who weren't necessarily going to hospitals, who weren't necessarily going to see doctors, and who, by the way, had a mistrust of kind of the broader public health establishment who might not have been willing to speak with contact tracers and that sort of thing. Some of those people were showing up to Nancy's store. In fact, many of those people were showing up the Nancy store.

She said sometimes 200 a day would come in, asking for her advice, asking for what sorts of health products she would suggest that they use. And so her store, Health to You, became sort of measles central in this area. And she herself, in many ways, became the preeminent expert in the area because you had public health authorities who were doing things like testing sewage and effluent to look for relative level. of measles to get a sense of whether it was still expanding or whether it was contracting, that sort of thing. But she had the actual families, the children, coming into her store and telling her what they were experiencing and that sort of thing. And that included finding out some details about when it first came to Seminole. So, Nathan, do we know how the measles got to Texas? I spoke with a doctor who treated the first confirmed case. And she said, I don't know.

their family had no information about travel or anything else. So this is what was for me incredibly interesting about speaking with Nancy and about Nancy's kind of privileged role of trust in this whole measles outbreak. She said in early January she was in the store when a couple of women came in, one of whom had traveled 120 kilometers down to her store and said, we had guests over for Christmas. One of those guests then said that they had been a confirmed contact with measles. They had discovered that while they were in Texas. They weren't feeling well.

And they left, what should we do? This was early January. The first confirmation of the measles in Seminole didn't come until the very end of the month. And Nancy, at that point, had not dealt, just like the medical establishment, had not dealt with measles for decades and was like, oh, I don't really know. So she kind of sent them on their way with a couple of products. But then she said, I told my daughters who work at the store with her, we need to be prepared. There might be something coming here. And then she said over the course of the next couple of weeks, it went quiet for a little bit.

But then she started to get pictures on her cell phone of people sending these pictures of children with rashes, which is a very distinctive measles rash. And those started arriving well in advance of that first confirmed case. But what was interesting was those two women who came to restore said our guests, our Christmas guests, who'd come down as measles exposed cases, came from Canada. And that matched with what the public health authorities had assumed. But what Nancy was told was a pretty strong indication of measles itself traveling from Canada down to Texas. Wow. So, Nathan, we know the source of this outbreak began in October of 2024. and the measles is also still spreading today.

And it seems like the spread of measles was especially bad in Canada. So why was it able to get this out of hand? Because we're talking about a virus that was declared eliminated 27 years ago in Canada. Well, I think there's a number of reasons for that. One is that you have had a community of people across Canada, this Mennonite community that's kind of interconnected with itself and that has had lower vaccination rates. And so that has provided a population for the measles to spread through. And we've seen that in Ontario. We saw that in New Brunswick.

We saw that in Alberta as well as Texas. So that's part of it. But we've also had declining measles vaccination rates across the Canadian population. Those are way down from, say, the 95% that public health authorities would like to see to ensure the measles continues to stay eliminated. We're now down as far as low as 83%. And so we've seen this. across Canada is this rising reluctance to vaccinate children, in particular, against the measles. And so that's provided a venue for this. It's not the first time this has happened,

particularly in sort of one community. But in this case, it's just continued to spread across Canada. So we're talking about the Mennonite community in this particular outbreak. Has it traveled outside of that community as well? Yes. We have seen cases outside the Mennonite community as well. But I think many of the cases have been within that community. What did you learn from your reporting about how people are generally feeling about public health measures like getting vaccinated or contact tracing? Well, I think it really depends. But I think what we have seen is we have gone from a situation where when the measles

vaccine was first developed in the 50s and 60s, where parents were almost lining up to provide their children to get an experimental jab, one that hadn't even yet been approved to a place now where increasing numbers of parents are reluctant to do this. And all of this was accelerated by COVID. I mean, I think there was a feeling that the COVID vaccine and the experience with COVID and some of the measures that were taken to try to push people to get vaccinated were an infringement of people's personal freedoms and medical choices and this sort of thing. And so all of that has built up into something else. That doesn't change the fact that the measles vaccine is still incredibly effective, but you can understand

how that might change the way people feel about vaccines. So these medical experts that you spoke to on the trip, did they have any strategies that would combat this hesitancy? One of the things that I find interesting is the disconnect between the medical establishment and the political establishment. And I wonder if this is an area that that needs to be looked at. I mean, even in New Brunswick, which is where a lot of this started, many of the local politicians at the local level, as well as at the provincial level, didn't have a whole lot of idea of what was going on. Was that their own lack of curiosity, or was that the fact that they weren't actually brought into the loop on this? I don't know. In southern Thailand, they've done a number of things.

They try to go door to door in some areas to try to offer vaccines to people. In some cases, they've offered sort of effective payment through food and other things to people who get vaccinated. And another person that I spoke with in southern Thailand said, what they've been trying to do is They're trying to reach people in the ways that they are communicating right now. So WhatsApp groups at schools and that sort of thing. So new communication methods, more direct offering of the vaccine. In Canada, one of the doctors I spoke was suggested maybe we need to start looking at not just promoting vaccines to children and in schools, but also perhaps promoting vaccines to travelers

because, of course, it's travelers who are going into places where some of these diseases remain endemic. And so I think there's a lot of important questions that still need to be pondered. So, Nathan, we started this conversation at this wedding and with Leah, who is the first case of this outbreak in Canada and in North America. I'm a bit surprised that she and her family have come forward about beginning the spread. How does she feel about all of this? Deeply apologetic.

She had no idea that there was a measles outbreak in the place where she was living in southern Thailand. And she had no idea that she could potentially have had the measles. And I think there's evidence for that because had she thought that she had the measles, presumably she would have been tested for that immediately in her first visit to the hospital. And instead they thought perhaps it was scarlet fever, strep throat, some other things, not the measles. That didn't come out until later. So that was a total surprise. But also, my sense is this is a family that tried, particularly once the measles diagnosis, came through, to do everything in its power to stop its spread. I mean, the family in New Brunswick run a small church.

They shut that church down for weeks. They run small businesses. They shut those small businesses down for weeks as well in hopes of containing everything. So they did what they could. And I mean, this really could have happened to anyone. One of the public health people I spoke with said that the situation in North America with declining vaccination rates was akin to a forest that grows drier and drier. And as it continues to grow dry, it only takes a spark. And at some point, a spark is going to materialize that sets off a broader fire.

Nathan, thanks so much for being on the show today. Thank you. That was Nathan Vanderclip, the Globe's international correspondent. That's it for today. today. I'm Cheryl Sutherland. Our producers are Madeline White, Michal Stein, and Ali Graham. David Crosby edits the show. Adrian Chung is our senior producer, and Angela Pichenza is our executive editor. Thanks so much for listening and I'll talk to you soon.