Canada's loss of measles elimination after 27 years: a mathematical modelling analysis of the five major provincial outbreak waves in 2025-2026

Background. Canada's loss of measles elimination status in 2025 highlighted the vulnerability of populations with concentrated immunity gaps. Provincial incidence alone cannot readily distinguish relatively intense transmission within a small susceptible population from transmission involving a larger population. We quantified these differences across five provincial measles waves in 2025-2026. Methods. We fitted a common susceptible-exposed-infectious-recovered (SEIR) model to weekly reported measles incidence for Ontario in 2025 and Alberta and Manitoba in 2025 and 2026. Mean latent and infe

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