Â鶹´«Ã½Ó³»­

TORONTO — One person has died in a Toronto outbreak of meningococcal disease, the city's public health unit said Thursday.

The disease is considered rare in Canada but it's of renewed concern for experts as vaccination rates for immunizations typically given in school have fallen during the pandemic. 

Toronto Public Health said it had confirmed three cases of invasive meningococcal disease in people between 20 and 30 years old who began experiencing symptoms between July 15 and 17.

All three people were born outside of Canada in countries that don't provide childhood immunization against the disease, public health said.

A link between the cases was not identified but public health said the three people had recently been confirmed to have the same rare strain of serogroup C meningococcal disease.

Meningococcal disease refers to illnesses caused by bacteria called Neisseria meningitides, which are often severe, can be deadly and can cause meningitis and infections of the lining of the brain, spinal cord and bloodstream.

"It's quite serious," public health physician Dr. Jia Hu said from Calgary.

Meningococcal disease is one of several conditions that children must be immunized against to attend school in Ontario. 

Provincial guidelines say babies should receive vaccinations for the disease at 12 months old, and another shot is given to Grade 7 students in public school.

Hu, who is also CEO of the non-profit group 19 to Zero that aims to boost vaccine uptake, said Canada has traditionally had strong immunization rates for vaccine-preventable diseases, making outbreaks like the one in Toronto "fairly rare."

But he pointed out that the pandemic has caused many children to fall behind on immunizations, particularly those that are typically given in school.

A Public Health Ontario report on provincewide coverage for school-based vaccination programs noted that the COVID-19 pandemic "has posed significant challenges to the delivery of immunization services in schools," because schools were closed for extended periods of time and staff were redeployed to COVID-19 response efforts. 

The report showed that the meningococcal disease vaccination rate among Ontario 12-year-olds plummeted to approximately 17 per cent in the 2020 to 2021 school year, down from 67 per cent the previous school year. 

Dramatic drops in vaccination coverage were also seen over the same period for human papillomavirus and hepatitis B vaccinations, the report said. 

Public health units across Ontario are in the process running catch-up clinics to get shots to students who have fallen behind. 

Hu said occurrences such as the Toronto meningococcal disease outbreak and the detection of polio virus in wastewater in New York City and other locations worldwide should remind people of the importance of catching up on shots for vaccine-preventable illnesses.

"Vaccination is very effective, but we need people to be vaccinated," he said. 

Infectious disease specialist Dr. Zain Chagla said meningococcal disease outbreaks are rare, but can happen in dormitories and universities as well as other congregate settings including military barracks.

"It is devastating for young people," he said.

"It can lead to young people dying or lead to young people getting seriously ill, even if they get medical care in a rapid fashion." 

Chagla, who works at St. Joseph’s Healthcare Hamilton, said there has been one or two cases of the disease a year in Hamilton for many years.

"It's rare, but when it happens, it is one of these diseases where the outcomes are so bad that we really, really want to get control of it very quickly," he said.

Early symptoms of meningococcal disease include fever, aches, joint pain, headache, stiff neck, sensitivity to light and can often be similar to signs of flu and other viral infections, making it difficult to diagnose. 

Meningococcal bacteria is spread by sharing respiratory and throat fluids, typically through close contact like kissing, coughing, sharing utensils, cups, cigarettes and musical instruments.

The health unit is recommending that all adults between 20 and 36 years old who have not received a meningococcal disease vaccine contact their health provider to receive one as soon as possible.

- With files from Tyler Griffin and Maan Alhmidi

This report by The Canadian Press was first published Aug. 25, 2022.

Holly McKenzie-Sutter, The Canadian Press