Washington Governor Jay Inslee declared a local public health emergency in mid-January due to an outbreak of measles in Clark County, Washington. As of Thursday, 41 confirmed cases of measles and 15 suspected cases have been reported in Clark County, along with one case of measles in Multnomah County and two exposure sites in Bend, according to a press release from the Center for Human Development in La Grande.
Amy Miles, infection preventionist at Grande Ronde Hospital, Carrie Brogoitti, public health administrator at CHD, and Elizabeth Sieders, communicable disease nurse at CHD, agree the odds for measles to appear in Union County is likely, due to the rate at which the disease spreads and the number of unvaccinated children in the area.
Measles, according to Oregon Health Authority, is highly contagious, as the virus can remain airborne for up to two hours after an infected person coughs or sneezes. Initial symptoms, which typically appear seven to 14 days after a person is infected, include high fever, cough, runny nose and red, watery eyes. Two or three days after symptoms begin, small white spots may form inside the mouth, while a rash usually first appears on the face and spreads across the skin three to five days into experiencing symptoms. The Centers for Disease Control and Prevention note that a few days after the rash appears, the fever goes down and the rash clears up.
“Measles is highly communicable, and the part people don’t understand (are) the complications that go along with having the disease,” Miles said.
Complications include pneumonia, the No. 1 cause of death for children who contract measles, and encephalitis, which is the swelling of the brain. The CDC reports children younger than 5 and adults older than 20 are most likely to suffer from measles complications.
If you think you have been exposed to measles, are exhibiting symptoms and are not vaccinated for measles through the MMR vaccine, CHD and GRH recommend calling ahead to your health care provider for an over-the-phone assessment instead of visiting in person in order to reduce measles exposure to the rest of the community.
“We’re encouraging people to call first, but that does not mean we aren’t going to see them,” Miles said. “We’re doing a pre-assessment, and if they absolutely need to come in, we wouldn’t deny them. It allows us to be prepared and get them into the facility in a way that would be safe for everyone.”
If you are unsure whether or not you’ve been vaccinated for measles, Sieders suggests to check your immunization status.
“This is a great time to dig out those records or call us and we can look them up for you to see if you are vaccinated,” she said.
Every Friday from 8 a.m. to 3 p.m., CHD offers vaccinations with no appointment necessary, but because of the current outbreak in Washington, they are focusing on the MMR vaccine in particular on Feb. 8.
“The idea of having a special measles vaccination clinic is to really call attention to the fact that there’s a need for that vaccine at this point in time,” Brogoitti said. “With measles, there is a vaccine that’s highly effective. If you have that vaccine, the chances that you’ll get the disease is pretty close to none.”
CDC recommends all children receive the MMR vaccine twice, with the first dose between 12 and 15 months of age, and the second dose between 4 and 6 years of age. Receiving two doses of the MMR vaccine is 97 percent effective against the disease, while one dose is 93 percent effective, according to the CDC website.
Since the measles vaccine was introduced in 1963, there has been an estimated 99 percent reduction in cases of the disease in the United States. By 2000, measles was declared eliminated in the U.S. However, the World Health Organization reports there has been a spike in measles in the U.S. since 2017 due to gaps in vaccinations.
“The resurgence of measles is of serious concern, with extended outbreaks occurring across regions, and particularly in countries that had achieved, or were close to achieving, measles elimination,” said Soumya Swaminathan, WHO’s deputy director general for programmes, in a press release. “Without urgent efforts to increase vaccination coverage and identify populations with unacceptable levels of under-, or unimmunized children, we risk losing decades of progress in protecting children and communities against this devastating but entirely preventable disease.”
Some parents fear their children will develop autism from vaccines, according to CDC. However, vaccine safety experts at CDC and the American Academy of Pediatrics, agree that vaccines, including the MMR vaccine, are not responsible for increases in the number of children diagnosed with autism spectrum disorder.
“Despite the evidence that the MMR vaccine is extremely effective and extremely safe, there’s still the anti-vaccination movement,” Sieders said. “Measles is a serious disease. We want to call attention to that.”
In 2017, only 86 percent of Union County children ages 19 months to 5 years old received their first dose of the MMR vaccine, according to the Oregon Immunization Program. The CDC’s state data of a similar age group reports 90.3 percent of children across Oregon ages 19 to 35 months received one dose of the MMR vaccine in 2017. According to WHO, 93-95 percent of a population must have immunity to measles in order to meet the threshold for herd immunity, which is defined as the resistance to a disease in a group of people due to the high number of those with immunity.
Brogoitti notes for this reason, it’s important for adults to get vaccinated too.
“Children (younger than) 12 months are not able to get vaccinated, so the best way to protect them is to have the adults and other children who are around them be vaccinated,” Brogoitti said. “Protect the people who aren’t able to get the vaccine. For me, it’s not just about protecting me and my family, it’s about protecting my community.”
For more information or to set up an appointment, call Center for Human Development at 541-962-8800.