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A student receives a measles vaccine injection.VALENTIN FLAURAUD/Reuters

With two confirmed cases of measles in B.C.'s Fraser Valley and about 100 other suspected cases, provincial health officials are gearing up for another outbreak of the easily transmitted, highly contagious virus.

The fight began last summer, and by fall appeared to have been successful. But because so many people have been exposed to the two new cases reported in Chilliwack, a community about 100 kilometres east of Vancouver, there are fears the disease will spread quickly in the area, where vaccination rates are low (60 to 70 per cent).

"We're going backwards in terms of vaccinations," said Monika Naus, medical director at the B.C. Centre for Disease Control. "We have people who won't get them. They're sitting ducks."

The two Chilliwack cases, both in school-age children, forced Mount Cheam Christian School to shut down a week before its scheduled March break. The school is working with the Fraser Health Authority, but is not forcing its students to be vaccinated. Neither is B.C. Health Minister Terry Lake. He said the government will not make vaccinations mandatory, although he urged parents to have their children immunized.

Vaccination is not mandatory in most of Canada. Public health officials prefer to educate rather than force people to do it.

The cases in Chilliwack have some resemblance to November's measles outbreak in southern Alberta, where the confirmed count topped out at 42 before being declared over. A student at the Coaldale Christian School who had been to the Netherlands contracted measles and set off the chain reaction. To counter the spread of the virus, health workers launched a public awareness campaign, talked to schools and set up mobile immunization centres. It was a daunting task given religious beliefs and concerns the measles vaccine could do more damage than the illness.

"In this particular community [in Chilliwack], they see it as God's will," Dr. Naus said of the resistance to the measles vaccine. "You don't take that decision making out of God's hands. … The tools to prevent [measles] are all there. It's just an uptake of the tools."

B.C. Health may set up drop-in centres for immunization, but it is also hoping arrangements can be made for people to be vaccinated privately. Health workers are contacting families to offer the vaccine.

There have also been plenty of warnings about measles and its symptoms – high fever, a rash, coughing, runny nose, white spots inside the mouth. The virus can thrive in the air for two hours and infect people who breathe it in, making it extremely contagious.

Paul Van Buynder, the chief medical officer for Fraser Health, issued a statement asking people to get immunized, especially if they're planning to leave the country.

"We are urging individuals who may have been exposed to the virus to contact their local public health unit to be cleared before travelling during spring break," Dr. Van Buynder said. "The potential for this virus to spread as a result is very concerning."

B.C. had sporadic importations of measles last year. Most, the B.C. Centre for Disease Control said, have come from the Philippines, where an outbreak is reported to have killed more than two dozen children. Medical officials across Canada have told health-care workers to be alert for measles cases linked to the Philippines.

Public health officials in Ottawa last week confirmed a case of measles in a student of a Catholic school who travelled to the Philippines.