A child under five years old has died of measles in Ontario, according to the province’s public health agency, the first such death in more than a decade.

In a report published Thursday, Public Health Ontario said the child was not vaccinated against the highly infectious respiratory virus. It did not indicate when or where the child died, or their specific age. 

The report shows there were no other measles-related deaths recorded in the province between Jan. 1, 2013 and this week.

Measles has been on the rise in both Ontario and elsewhere in Canada as cases increase globally.

There have been 22 cases in the province so far this year, Public Health Ontario says — level of infections matching a recent high set in 2014, when there was the same number over the entire calendar year.

All of the cases were in people born after 1970, including 13 children. In 12 of those instances, the children were unimmunized, while the vaccination status of one was unknown.

Five infections, all in unvaccinated children under five years old, required hospitalization, the report says.

Most of the total cases, 15 of 22, were linked to travel, Public Health Ontario says.

“In Ontario, measles has been rare, owing to the successful elimination of measles in Canada and high immunization coverage. As a result, measles cases are predominantly associated with travel,” the report says.

“Due to an increase in measles activity globally, Ontario has begun to see more cases of measles.”

Dr. Isaac Bogoch, an infectious diseases consultant at Toronto General Hospital, says Canadians planning to travel should ensure they are up to date on their measles vaccine given the rise in infections abroad.

“The vaccine is extremely effective. It’s safe, it’s widely available, and it’s free. Is it perfect? Of course not. Nothing’s perfect, but it’s really, really, really good,” he told CBC Radio’s Metro Morning on Friday.

Bogoch said interruptions to routine childhood vaccination schedules during the COVID-19 pandemic means that some young children may have missed a dose.

For Canadian children, the typical schedule is now two doses, both administered before they enter school. The first dose of the combined measles, mumps and rubella (MMR) vaccine should be given when a child is 12 to 15 months of age and the second at 18 months, or any time after that, but no later than around school entry, notes the Canadian immunization guide. 

For infants set to travel internationally with their caregivers, especially to destinations with high rates of measles infection, the first shot can be moved up to six months in some cases, Bogoch said.