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Measles to flesh-eating disease: What B.C. travellers should know about overseas health risks

The first case of measles in B.C. in five years has sparked concern about travel.
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A Vancouver firefighter recently lost his leg to a strep A infection and there is a measles outbreak in Canada. Get tips about travel and vaccines in 2024.

Are you at a greater risk of being infected with measles, flesh-eating disease or another life-threatening bacteria when you travel overseas? 

A Vancouver firefighter recently travelled to Hong Kong with his partner and developed flesh-eating disease from a strep A infection, forcing the amputation of his leg.

While it may seem surprising, you are always at risk of contracting flesh-eating disease or measles - no matter where you are in the world.

There are also a host of other bacteria and viruses that you can contract at home in Metro Vancouver or while travelling within B.C.

But there are several destination-specific illnesses and viruses that you need to be aware of before you pack your suitcase and board your flight. 

Travel Medicine and Vaccination Centre Nurse Health Education Specialist Colleen Jeffery told V.I.A. that many destinations come with their specific risks, including mosquito-borne illnesses, infectious diseases, unsanitary water, and many others.

While travellers can be immunized against some viruses, many of them do not have vaccines. In these instances, the clinic provides advice on how to avoid getting ill. 

Mosquito-borne illnesses, such as dengue fever and West Nile virus, don't have vaccines. However, there are several steps travellers can take to prevent infection, such as using repellent, protective clothing, or avoiding areas where they are more prone to be. 

Some people are not able to handle "live, attenuated vaccines" that are designated to prevent viruses including measles, mumps, rubella, smallpox, rotavirus, and yellow fever. These types of vaccines use a little bit of the weakened live virus to create immunity.

Babies under six months of age and people who are significantly immunocompromised or pregnant may not be able to take live vaccines. 

B.C. measles case sparks increased concern for traveller vaccination 

Measles was a common disease before a vaccine was developed but has been eliminated in Canada. However, the first case of measles in B.C. since 2019 was recently identified in a child under 10 in the Vancouver Coastal Health (VCH) region, sparking concern among health officials. A public warning was issued on Monday, March 4.

In 2024, 16 cases of measles have already been reported in other parts of Canada compared with 12 in all of 2023. Montreal has the highest number of cases, with 10. 

Provincial health officer Dr Bonnie Henry said the Metro Vancouver measles case is linked to travel and advised all parents to ensure their children's immunizations are up-to-date.

Babies as young as six months should be vaccinated against measles before travelling to countries where the disease is spreading, says a joint bulletin issued by Henry's office, the provincial government and the BC Centre for Disease Control (BCCDC). 

Children between the ages of 12 months and four years can also get their second dose before travelling outside the country.

The U.S. Centres for Disease Control says that the COVID-19 pandemic worsened the spread of measles because over 60 million doses of measles-containing vaccine were postponed or missed from 2020 to 2022. It also shows a list of countries with the highest numbers of cases. The top three countries with the most infections are Yemen with 18,464,  Azerbaijan with 13,721, and Kazakhstan with 13,195.

The World Health Organization reported a 79 per cent increase in the number of global measles cases in 2023 compared with the previous year. 

Can anyone contract a "flesh-eating disease" overseas?

Dr. Monika Naus is the medical director of the Immunization Programs and Vaccine Preventable Diseases Service with the BCCDC. She says Group A streptococcal infections occur at "far higher" rates in some countries than in Canada. 

With severe flesh-eating disease infections, like the one the firefighter had, "amputations are uncommon," she told V.I.A. 

"The primary symptom of necrotizing fasciitis is pain typically well beyond what would be expected following a cut or blunt trauma," she explained.

"It tends to occur in the long muscles of the leg or arms. It is considered a surgical emergency and requires prompt release of the pressure and typically debridement of necrotic tissue as well as antibiotic treatment."

It's cases like this that highlight the importance of purchasing a comprehensive travel insurance plan that includes robust medical coverage for emergencies, said Jeffery. 

Some insurers provide up to $10 million in emergency medical coverage for a single trip, while others may pay a million or less. While a million may seem like far more than you could need, in the event of an emergency, particularly in the United States, you could face much higher costs. If you need to be transported by air from one city to another, for example, costs could quickly climb.

Travel health is "not a one-size-fits-all approach." 

Jeffery adds that each consultation varies depending on the destination and the health of the individual.

"If you have an elderly person with chronic health [problems] going to Papua New Guinea versus a healthy 30-year-old professor, that will be different," she explained.

"It's not a one-size-fits-all approach." 

In some instances, a client may be advised against travel to specific destinations based on their current health and the risks involved. Also, not every traveller going to the same destination will be given the same advice - even if they are both healthy. 

"There is an individual risk assessment. A four-star business trip in an air-conditioned room for four days versus backpacking for three months [across the country] will be different," she said. 

Jeffery notes that performing a quick search online for a destination won't provide the most up-to-date information about a country's current epidemiological status.  

With files from the Canadian Press.