A huge outbreak has made Ontario the measles centre of the western hemisphere

Three-quarters of cases are in unvaccinated children, and this week saw the first fatality: a premature baby

Outside the emergency room of the St Thomas Elgin general hospital, about 200km (125 miles) south-west of Toronto, a large sign with bright yellow block letters issues an urgent warning: “NO MEASLES VAX & FEVER COUGH RASH – STOP – DO NOT ENTER!”

To see such an imperative in the 21st century might have been previously unimaginable for Canada, which in 1998 achieved “elimination status” for measles, meaning the virus is no longer circulating regularly.

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