Resurgent Infectious Diseases Raise Alarm in Quebec, Sparking Vaccination Concerns
Quebec is facing a concerning rise in preventable infectious diseases – including syphilis, measles, and tuberculosis – prompting public health officials to warn of declining vaccination rates and the potential for outbreaks of diseases once considered relics of the past. The situation underscores a growing vulnerability as immunity wanes and societal factors contribute to the spread of illness.
A Looming Threat: Declining Vaccination Coverage
A key driver of the resurgence is a drop in vaccination coverage across the province. “The first thing we’re going to see when we roll back vaccination coverage is an increase in measles, but moreover, if all the other vaccines continued to fall behind, there’s nothing to say that we couldn’t see cases of polio again,” cautioned a senior public health official. The specter of polio, though currently present elsewhere – with recent detection of the virus in German wastewater – highlights the fragility of protection. Even without confirmed cases, the presence of the virus indicates potential transmission and risk to unvaccinated individuals.
Vaccines are critical not only for preventing the spread of infectious diseases but also for mitigating their severity. For example, declining pneumococcal vaccination rates could lead to a rise in pneumococcal meningitis, potentially causing long-term neurodevelopmental damage, deafness, or even death. As vaccination rates fall, the collective immunity that once protected vulnerable populations – those too young or unable to be vaccinated – is eroding.
Historical Context and Modern Challenges
Experts emphasize that the current situation isn’t entirely unexpected. A leading infectious diseases specialist at a Montreal hospital noted a societal shift in attitudes towards vaccination. “We have become a rich society where we have the leisure to ask ourselves whether or not we should vaccinate our children,” he observed, contrasting current hesitancy with the experiences of previous generations who lived with the constant threat of these diseases.
The COVID-19 pandemic inadvertently demonstrated the impact of reduced mobility on disease transmission. During periods of lockdown and travel restrictions, the incidence of many infectious diseases plummeted, illustrating their connection to human movement and exchange. However, with the return to normalcy, these diseases have begun to reappear.
Tuberculosis: A Persistent and Growing Problem
Quebec is currently grappling with a significant tuberculosis (TB) outbreak. As of December 13, 2025, 493 cases have been declared province-wide, with 203 concentrated in Montreal. The situation is particularly acute in Nunavik, where 112 cases represent one of the highest per capita rates globally.
TB, a disease with roots stretching back to ancient Egypt – evidenced by skeletal deformities in mummies dating to 2400 B.C. – remains a major global health concern. The World Health Organization estimates 10.8 million new active cases in 2023, a 2-3% annual increase since 2020. While most infected individuals (90%) never develop active TB, untreated cases can infect 10-15 others annually.
Addressing the outbreak in Nunavik requires a multifaceted approach. A key factor contributing to the high rates is overcrowding due to a lack of adequate housing. Public health teams are actively screening for asymptomatic carriers, but officials acknowledge that addressing the root causes – including housing shortages – is crucial. “We are trying in a concerted manner…to control the outbreak as best as possible, but that does not only take treatment and screening, it also takes many other elements, such as housing,” a senior official stated.
Measles Outbreaks and the Importance of Herd Immunity
Quebec has experienced two measles outbreaks in 2025, with around forty cases reported. Canada lost its status as a measles-free country this year due to significant outbreaks, particularly in Alberta and Ontario, which have seen over 2,000 cases.
Maintaining a vaccination coverage rate above 95% is essential for achieving herd immunity and preventing measles outbreaks. However, current coverage in Quebec varies significantly by region, ranging from 83% to 96%. As a public health expert explained, “Measles, as long as it exists somewhere on the planet…from the moment vaccination coverage decreases, there is a risk of seeing an imported case spread locally.”
The Rise of Congenital Syphilis: A Preventable Tragedy
Alongside measles and tuberculosis, Quebec is also witnessing a concerning increase in syphilis cases, with 1,258 reported in 2022, including nearly 700 in Montreal. More alarmingly, there were 14 cases of congenital syphilis – where the infection is passed from mother to child. Data for 2023 is expected in January 2026.
Congenital syphilis is particularly troubling because it is preventable through timely testing and treatment during pregnancy. A public health official expressed concern that, “The mother should have been tested during pregnancy and treated if she tested positive, but was not, either because she did not have access to care or for another reason.” Public health is evaluating strategies to repeat syphilis testing in the third trimester and at birth to ensure prompt treatment for both mother and child.
Strategies for Improvement and a Long-Term Perspective
Quebec’s public health authorities are implementing strategies to improve vaccination coverage, including the EMMIE program, which provides new parents with personalized vaccination advice in maternity units. The focus is on education and addressing parental concerns rather than mandatory vaccination.
Ultimately, experts emphasize that infectious diseases are a persistent reality. As one physician noted, “We must understand that these diseases have never been eradicated on a global scale. It’s very pretentious for humans to think of eradicating infectious diseases like that.” While eradication may be unrealistic, continued vigilance, robust vaccination programs, and addressing underlying social determinants of health are essential to minimizing their impact and protecting public health.
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