Outside the emergency room of St Thomas Elgin General Hospital, located about 200km (125 miles) south-west of Toronto, a prominent sign with bright yellow letters delivers a serious message: “NO MEASLES VAX & FEVER COUGH RASH – STOP – DO NOT ENTER!”
Seeing such a warning in the 21st century might have seemed unimaginable for Canada, which achieved “elimination status” for measles back in 1998. This meant that the virus was no longer spreading regularly.
However, Canada now faces the risk of losing that status due to a rapid outbreak of this highly contagious and sometimes fatal disease in southwestern Ontario, where St Thomas hospital is situated.
Since October, the province has reported an astonishing 2,009 cases linked to this outbreak – more than all cases recorded in the United States combined in 2025. This makes Ontario the epicenter for measles in the western hemisphere.
Case numbers have surged by hundreds over the past month, with Public Health Ontario noting that three-quarters of those affected are unvaccinated children.
This week marked the first death associated with this outbreak: a premature baby who contracted measles while still in utero from their unvaccinated mother. Kieran Moore, Ontario’s chief medical officer of health, mentioned that while the infant had other unrelated medical issues, measles may have played a role in both their premature birth and subsequent death.
“We haven’t seen an outbreak of this magnitude within our community during my entire career. Many doctors have never even encountered measles until now,” said Asmaa Hussain, head of pediatrics at St Thomas Elgin General Hospital.
Hussain suggested that the actual extent of this outbreak could be even greater.
“There are probably many children and families at home who had measles but never came to our hospital,” she explained. “The confirmed cases represent only a small fraction of what’s really happening within our community.”
A sign outside Southwestern Public Health in St Thomas, Ontario, on 4 March 2025. Photograph: Geoff Robins/Canadian Press via AP/Alamy
Almost 40% of cases reported in Ontario come from the Southwestern Public Health Unit, which covers Oxford County, Elgin County and St Thomas city-all about two hours’ drive south-west from Toronto.
While it’s shocking how widespread this outbreak has become, frontline doctors and public health scientists say that it was somewhat expected given recent trends.
A mix of outdated local vaccination strategies, limited access to family doctors, delays caused by Covid-19 related shutdowns for routine immunizations and increased vaccine hesitancy fueled by online misinformation since the pandemic all contributed to this situation.
Southwestern Ontario is also home to close-knit religious communities hesitant about vaccines who often miss out on public health messages-like some Mennonites. This current outbreak can be traced back to a Mennonite wedding held in New Brunswick where a guest returned with measles to Ontario.
At the same time, case counts are rising in Alberta as well; this week saw reports confirming a total of 710 cases there-marking its worst year for measles since 1986 when there were 843 cases reported.
Measles presents symptoms like fever, cough and distinct rashes ranging from red to purple or brown across large areas. It can lead to severe outcomes like brain damage or blindness and even death but is easily preventable through vaccination. Canada aims for at least 95% immunization coverage among its population to prevent outbreaks.
Unfortunately, vaccination rates have dipped below that threshold; first-dose coverage nationwide dropped from 90% in 2019 down to just 83% by 2023 according to data from the Public Health Agency of Canada.
In St Thomas..
Hussain revealed she’s treated numerous babies under one year old for measles this year. Infants typically aren’t eligible for vaccines until they reach age one; however last month guidelines changed allowing infants living within southwestern Ontario to receive their first dose as early as six months old. In many situations these babies catch it from older siblings who haven’t been vaccinated after picking up viruses at school.
She also noted treating an unvaccinated woman infected by her kids before passing it on to her newborn right after delivery.
Although it’s against regulations for unvaccinated kids not being allowed into schools unless they’re immunized against various diseases-including measles-there are exemptions available based on valid medical conditions or personal beliefs tied closely enough religiously.
When dealing with families presenting at healthcare centers showing signs associated with Measle infections Doctors sometimes find themselves struggling initiating discussions around vaccines altogether , Hussain stated.
“It’s challenging just starting off conversations like these. I’ll ask them ‘Why aren’t you [vaccinated]?’ And responses range anywhere from ‘Oh we’ve got exemptions’ or ‘We’ve talked about it already so we won’t,’” she recounted.
Dawn Bowdish , an immunologist/professor working out Mc Master University remarked how rising distrust concerning vaccinations coupled alongside Canada facing shortage among family physicians only exacerbated factors leading towards outbreaks occurring today(Sources cited).
About twenty percent (20%) Canadians lack established relationships/follow-up appointments needed care whilst majority others struggle finding regular clinicians resulting ultimately depriving parents direct access support regarding important conversations surrounding vaccinations themselves. Additionally absence existing comprehensive national registries tracking individual histories adds another layer complication figuring own respective statuses contributing further confusion amongst populations concerned primarily around these matters.
Bowdish warned although exemption policies continue evolving rapidly navigating legal landscape proves increasingly difficult because rules governing allowances becoming too lenient over time.(“One challenge remains loosened protocols related exemption criteria meaning folks may lack sincere motivations behind opting out chosen paths.”)(continued)“It becomes complex trying balance civil liberties alongside societal welfare aspects required effectively addressing pressing public health initiatives without compromising any individual freedoms involved.”(continued)This inquiry into response measures hasn’t led officials clarifying possible changes focused specifically towards addressing minority concerns raised directly stemming recent occurrences here within regions such shown previously emphasized stark need awareness promoting proactive outreach efforts aimed integrating marginalized voices resonating better outreach agendas actively engaging communities proactively reaching out collaboratively determined solutions tailored meeting unique needs varied contexts present today overall goal positive outcomes achieved through collective action undertaken together forward progress made collectively without leaving anyone behind!(continued)The announcement addressed creation specialized clinics offering improved accessibility options boosting vaccination uptake levels eventually reduce recurrence risks moving forward beyond current crises experienced throughout province currently underway battling ongoing battles waged daily fighting ensure safety everyone involved contributing healthy societies existing where everyone thrives regardless background societal challenges faced affecting many lives daily across board achieving common good united front standing strong together !(
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Hussain revealed she’s treated numerous babies under one year old for measles this year. Infants typically aren’t eligible for vaccines until they reach age one; however last month guidelines changed allowing infants living within southwestern Ontario to receive their first dose as early as six months old. In many situations these babies catch it from older siblings who haven’t been vaccinated after picking up viruses at school.
She also noted treating an unvaccinated woman infected by her kids before passing it on to her newborn right after delivery.
Although it’s against regulations for unvaccinated kids not being allowed into schools unless they’re immunized against various diseases-including measles-there are exemptions available based on valid medical conditions or personal beliefs tied closely enough religiously.
When dealing with families presenting at healthcare centers showing signs associated with Measle infections Doctors sometimes find themselves struggling initiating discussions around vaccines altogether , Hussain stated.
“It’s challenging just starting off conversations like these. I’ll ask them ‘Why aren’t you [vaccinated]?’ And responses range anywhere from ‘Oh we’ve got exemptions’ or ‘We’ve talked about it already so we won’t,’” she recounted.
Dawn Bowdish , an immunologist/professor working out Mc Master University remarked how rising distrust concerning vaccinations coupled alongside Canada facing shortage among family physicians only exacerbated factors leading towards outbreaks occurring today(Sources cited).
About twenty percent (20%) Canadians lack established relationships/follow-up appointments needed care whilst majority others struggle finding regular clinicians resulting ultimately depriving parents direct access support regarding important conversations surrounding vaccinations themselves. Additionally absence existing comprehensive national registries tracking individual histories adds another layer complication figuring own respective statuses contributing further confusion amongst populations concerned primarily around these matters.
Bowdish warned although exemption policies continue evolving rapidly navigating legal landscape proves increasingly difficult because rules governing allowances becoming too lenient over time.(“One challenge remains loosened protocols related exemption criteria meaning folks may lack sincere motivations behind opting out chosen paths.”)(continued)“It becomes complex trying balance civil liberties alongside societal welfare aspects required effectively addressing pressing public health initiatives without compromising any individual freedoms involved.”(continued)This inquiry into response measures hasn’t led officials clarifying possible changes focused specifically towards addressing minority concerns raised directly stemming recent occurrences here within regions such shown previously emphasized stark need awareness promoting proactive outreach efforts aimed integrating marginalized voices resonating better outreach agendas actively engaging communities proactively reaching out collaboratively determined solutions tailored meeting unique needs varied contexts present today overall goal positive outcomes achieved through collective action undertaken together forward progress made collectively without leaving anyone behind!(continued)The announcement addressed creation specialized clinics offering improved accessibility options boosting vaccination uptake levels eventually reduce recurrence risks moving forward beyond current crises experienced throughout province currently underway battling ongoing battles waged daily fighting ensure safety everyone involved contributing healthy societies existing where everyone thrives regardless background societal challenges faced affecting many lives daily across board achieving common good united front standing strong together !(
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