More countries in Europe are reporting cases of measles, the Public Health Agency of Canada says.
People are reminded to make sure their measles vaccination is up-to-date, regardless of their travel destination, the agency said.
In Europe, there were more than 21,000 cases of measles and 35 deaths last year, a fourfold increase in cases compared to the previous year. With more than 5,000 cases each, Romania and Italy had the biggest epidemics.
Germany and Ukraine are also among the countries with the highest number of cases, Canadian health officials say.
The federal agency said the list of countries with cases has been updated to include Latvia, Macedonia, Montenegro, and Norway.
Measles is a highly contagious disease. It can spread quickly from person to person by direct contact and through droplets in the air through coughs and sneezes.
The infectious disease circulates in most regions of the world including Africa, Asia and Europe.
In Canada, measles cases are introduced from travellers. Once measles arrives in Canada with an infected traveller, it can then be spread to groups of people who are not vaccinated and cause an outbreak, health officials say.
Health officials say that vaccination rates of at least 95 per cent are needed to prevent epidemics. In some regions of Italy, the rate is about 85 per cent.
Early symptoms of measles include small, white spots inside the mouth and throat. It often starts with a high fever and also causes a rash on the face and neck. While most people who get measles recover, it’s one of the leading causes of death among young children, according to the World Health Organization.