FREDERICTON -- Health officials in New Brunswick have confirmed another case of measles -- bringing the total to nine in the Saint John area -- and some officials predict the number could go higher.
Dr. Jennifer Russell, the province's chief medical officer, says the latest case is linked to a previous infection at Kennebecasis Valley High School.
On Friday, public health officials issued a directive that staff and students at the high school must receive a measles booster shot if they want to continue working and studying at the school.
As of Monday, more than 950 students and staff had been given the vaccine, and it was still available to the final few people who had not received it.
District school officials have cancelled a number of planned out-of-province class trips at two other schools in the district as a result of the measles outbreak.
"In light of the long incubation period of the measles virus, and the understanding that more cases of measles could possibly be confirmed in the coming days, it was decided not to take an unnecessary risk," district communications director Jessica Hanlon wrote in an email.
"Our greatest concern would be that a student could start to present symptoms while travelling, away from home and their regular health care provider, and in extended, close proximity to their classmates."
Early symptoms of the virus may include fever, cough or tiny white spots in the mouth.
Within three to seven days, a red rash will appear, first on the face and then spreading to the body, arms and legs.
Dr. Serge Melanson, an emergency physician in Moncton and president of the New Brunswick Medical Society, said he's not surprised by the number of cases. He believes the total could rise.
"Given the infectiousness and ease of spread of this particular virus, it's not all that surprising that we're up to nine. And that's despite public health and the regional health authorities doing an exceptionally good job getting out a lot of information to folks on what to do and how to contain it and to urge people to vaccinate," he said Tuesday.
"It has a very long incubation period, which means people can feel relatively well for a good week or two weeks before they display symptoms, which means they have a lot of opportunity to transmit it to other folks," Melanson said.
Education Minister Dominic Cardy has said he's not ruling out mandatory immunization for teachers and school staff in the province. Russell has been asked if she thinks that's necessary but said that during an outbreak is not the time for that debate.
On Friday, legislators in neighbouring Maine signed into law a bill that eliminates religious and philosophical exemptions for vaccinations in the state. Maine has one of the highest rates of non-medical vaccine exemptions in the United States.
Melanson said he isn't prepared to push for the same action in New Brunswick.
"I'll leave those policy debates to those drafting those laws, but I will say there's little scientific doubt that the easiest, safest and best way to prevent the spread of these communicable diseases is by vaccination," he said.
"What the medical field can do better, I think, is attempting to debunk some of the messages that are out there in the community, on social media and other platforms that are promoting vaccination hesitancy."
The measles virus is transmitted through the air or by direct contact with an infected person. Measles can be more severe in adults and infants and can lead to complications.