Measles Outbreak Update


Hello I’m Jim Demmon with Clark County Close Up. Thank you for meeting with us. Thank you for having us on the show. OK. It’s March 21st. So what’s the latest with the measles outbreak? So in Clark County as of March 21st we’ve had 73 confirmed cases. Of those cases. Five of them were in adults. The rest of them, the other 68 were in children between the ages of 1 and 18. Of those cases, We’ve had three of those cases that I’ve had one of the two recommended vaccine doses. We’ve got another seven that are unverified weren’t able to tell one way or the other. And the other sixty three are documented as unvaccinated. So what we’re seeing here is an outbreak of measles in an unvaccinated population predominantly children. The children you know those those cases the 68 cases of between 1 and 18 are all children who have had should have had at least one shot at that point. But we’ve got an outbreak of measles in basically in unvaccinated children. But it has slowed down hasn’t it? Or but it’s still considered an outbreak. So. So here’s a you know in terms of the definition of an outbreak. An outbreak is defined as the incidence of disease or the occurrence of a disease in excess of what you would expect. For measles, we don’t expect any cases. We shouldn’t be seeing measles in Clark County. Until this year we hadn’t had any any confirmed cases since 2011. That was eight years ago. So even when we had that first case in late December early January that was an outbreak. I mean if we had one case of smallpox that would be considered an outbreak. One case of measles is really an outbreak. So we will define this outbreak as being over when we go what we call two incubation periods without a case. And when an incubation period is is a time from when you get exposed to the time that you’re likely to get symptoms which is between seven and 21 days after exposure. If we go 42 days without a case and I believe the most recent cases this past week I believe it was the 14th or so if we go 42 days after that we’ll declare the outbreak over. I’ll be happy if we go 21 days or go three weeks without a case. But the numbers are getting smaller. And I believe that our efforts to contain this have really helped with that. The numbers are getting smaller but we’re not we won’t declare it over until we go that 42 days without a case. OK. So what is the measles? So the measles is a viral infection. It’s a virus. And one of the things I want to say about this virus is it’s exquisitely contagious. It’s one of the most contagious viruses organisms that we know of. If you’re if you’re in a room. If you have measles and you’re in a room with other people who are unvaccinated none of them will get it. will get the disease. You can be you can leave if you have measles you can leave a room and two hours after you’ve left the room it’s airborne it stays in the in the environment. People can get measles. It’s that contagious. Even two hours after you’ve left the room. If you get exposed and your unvaccinated you’re susceptible. Somewhere between seven and 21 days you’ll get symptoms and the early symptoms of measles which makes it problematic during this time of year are what you’d see in other respiratory illnesses. So you have you’ll have a runny nose a cough and a pink or red eye cold conjunctivitis Actually we call it the three C’s because the runny nose the medical term for that is coryza a medical term for red eyes conjunctivitis cough coryza and conjunctivitis along with a high fever. Those are the early symptoms you’re incredibly contagious during those early symptoms and you don’t know you have measles yet until the rash appears which can occur several days after the those early symptoms and the rash generally starts on the head in the face and then gradually moves down to the to the rest of the body in the arms and legs. So and you’re contagious four days after the rash begins. So you’ve got about at least a week of being contagious. But what’s frightening is you’re contagious early on before you even realize that that that it’s measles. The only way not to realize that it’s measles I’m or or be worried about is if you’re vaccinated and so you don’t get it in the first place. The other thing I want to say about measles is it’s not. Despite the misinformation that’s going on around social media it is not a benign illness. It can be a very serious illness. Before before we had vaccinations routinely used in the United States in the early 60s 400 to 500 people in the United States died every year. About one in 1000 people who get measles will get encephalitis which is a swelling of the brain that can lead to damage including deafness. Before we had vaccination 4000 people in the United States every year got encephalitis or swelling of the brain. About forty eight thousand hospitalizations every year in the United States. Before we had the vaccine. You can also get pneumonia. There are a number of different complications. The mortality rate from measles is about one to three per thousand. So out of every one to three people who gets the gets measles that they will die. And what’s particularly concerning is that there are some groups that are at higher risk from measles which we can talk about but particularly infants who generally are too young to be vaccinated pregnant women who should have been vaccinated as children. But if they’re pregnant and unvaccinated they’re particularly at risk of complications including miscarriage and then people around us who are immuno suppressed they may be on cancer chemotherapy or have some other immune suppression. They are particularly at risk of getting infected and getting a complication. What should you do if either you believe you have measles or a family member what should you do? Yeah. Well one of the things you should not do so I’ll start with what you should not do. If you believe you have measles you should not go to an emergency department or you know to emergency room or doctor’s office because you’re exquisitely contagious and who are gonna find in an emergency room or doctor’s office? Infants pregnant women people with immune suppression. So you put other folks at risk. So you should stay home. You should call your health care provider. Call your doctor certainly if you have a life threatening emergency you need to call 9 1 1 but you need to you should call first and let you know if you’re calling your doctor’s office or the emergency room let them know you’re concerned about measles. We’ve we’ve given information out to health care providers on how to safely see people who are measles suspect without exposing everybody else in the doctor’s office or in the emergency room. You might note that during this outbreak we have had exposures that we’ve had to deal with in clinics and emergency rooms. So you mentioned earlier how can we prevent measles? Well there’s a very simple way to prevent measles? This whole outbreak was completely utterly 100 percent preventable. We have a incredibly safe effective and cheap vaccine that provides lifelong immunity. One dose of vaccine Ninety three percent effective. Two doses of vaccine a ninety seven percent effective. If everybody got vaccinated. We would be able to eradicate Measles. We thought we had measles eradicated nearly 20 years ago but we’ve seen an upsurge in cases because we still have populations that are unvaccinated And you said everyone should get vaccinated if they haven’t been vaccinated. What about for example. I think I was when I was a kid vaccinated. When I went through school? Yes. So there’s a couple of things that you can do. By the way there are people. One of the things I mentioned is you know when everyone we have to be careful. Pregnant women who haven’t been vaccinated before shouldn’t get vaccinated. Infants unless we get we get pretty nuanced here. If they are six to 11 months old and they’re traveling to a country where there’s a lot of measles they should get vaccinated. But otherwise everybody should be vaccinated somewhere between the first shot between 12 and 15 months of age and then a second shot between four and six years of age. Obviously there’s a very rare medical contraindications a child with a severe immunodeficiency shouldn’t be vaccinated but virtually the rest of us should be vaccinated at 12 to 15 months and then again at four to six years. If you’re an adult born before 57 virtually everybody was vaccinated with measles before. I mean not that I’m sorry. Virtually everybody born before 57 experienced measles because we didn’t have the vaccine at that time. And it’s so contagious virtually everybody got it. Those people are probably immune. If you want to if you want to be sure you can get your titers tech checked your you have a blood test to check that. If you work in health care you should you know you need to get your titers checked or in health care or you work and you know you work with populations or risk. You should have two shots. How safe is this vaccine? The vaccine is incredibly safe. We’ve had millions if not billions of doses given out. There’s a lot of there’s a lot of misinformation about the vaccine that’s out there and I want to counter some of that. One is that the vaccine causes autism. That is not true. That is total nonsense that’s been debunked many times there is no relationship no association between the vaccine and autism. There is also this nonsense on social media and I got to say nonsense is what it is that people who get the vaccine can shed the vaccine virus and infect other people. That’s been studied extensively. There’s been no documented transmission of the vaccine virus from one human being to another. So even if you have somebody in your family with for example immune deficiency you should get a vaccine. Those are exactly the kinds of folks that need to be protected by having all of us being vaccinated. So it’s safe in those situations are very few medical contraindications to the vaccine. One might be a severe immune deficiency another one might be a severe allergic reaction. Those are incredibly rare. There is nonsense out there about the vaccine causing seizures. Well anything that causes a fever and you can get a fever after a vaccine can result in a febrile seizure child febrile seizure which are horrible to look at but they’re generally benign. Measles which causes a high fever is so much more likely to result in a febrile seizure than the vaccine is. There is also rarely encephalitis from the vaccine incredibly rare. Much more likely far far far more likely with the disease with measles itself than it would ever be with a vaccine. So the vaccine is very safe. I mean it’s a very effective and very safe. But there’s there’s no heavy metals in the vaccine. You can take a look at the ingredients there. It’s a safe product but yet there’s this misinformation out there. And we’ve you’ve talked about this some of it’s very sophisticated looking. How do parents decide? I mean what recommendations do you have? Well that’s what’s so difficult for parents and I think the parents who are hesitant about vaccinating their children care about their children. I mean nobody’s questioning that. I know that they care about their children and they respond to some of this information. You can go to some of the Web sites. I think it’s called Physicians for informed consent. And it looks it looks scientific and it looks real but it’s nonsense. One one recommendation to parents you know talk to your doctor talk to your child’s health care provider about it. Don’t just rely on stuff you hear on the Internet. I you know, on on social media I know there are a lot of folks out there who are responding on social media are convinced that their children have suffered some severe effect of the vaccine. The problem with that is I think that it’s there’s a difference between causation and association so because things happen at similar points in time I think people it’s easy especially if there is misinformation out there to assume that one thing caused the other. You know we get that first shot for measles mumps and rubella 12 to 15 months. That’s the same time in development that children are being diagnosed with. For example autism people draw a conclusion between that even though thousands upon thousands of studies have shown there’s no association between receiving the vaccine and autism for example. So I tell parents you know talk to your talk to your health care provider about that so you get the appropriate information. The other thing I tell parents you know we need to listen to parents who are concerned by the way we need to talk to them about this stuff and listen to their concerns. The other thing I tell folks is that. One of the reasons to vaccinate your children is not only to protect your children but to protect everybody else around us which we have been seeing. Yes. Right. So you know during this outbreak we’ve actually had to provide something called immunoglobulin which is antibody preparation to infants who are exposed to cases. We’ve had to give it to pregnant women as well. So one of the reasons for vaccinating your children is to protect everybody around you. I know that some folks on social media accuse public health of wanting to mandate vaccines we’re not we’re not. I’m not suggesting that we hold anybody down and force them to have a vaccine. We’re saying that if you’re going to have your child in a school in a congregate setting where there are other children there may be infants if there is a daycare there and there may be children in school who have cancer on chemotherapy. If you’re going to have your children in school they should be vaccinated. You can choose still choose to homeschool your children but nobody’s mandating anything. We’re quickly running out of time. No no it’s fine. Go on. The one that I do want to talk about right now we’re we’re talking about an outbreak of measles but the same thing I would assume would apply with other vaccinations. If it could be another disease next if people aren’t getting immunized. Yeah. And we’ve heard about the child in Oregon who had tetanus. I think you heard about that case. I used to see when I was early on early on in age here but in all my early days used to see children with meningitis due to something called oneplus influenza. They’d also get something called epiglottitis where they’re swelling of the flap that covers the airway. We don’t see that much anymore because that’s one of the immunizations we provide. But that was a there was other vaccine preventable diseases that are pretty horrible that are preventable. Smallpox. Well yeah and actually smallpox is a good example. We don’t get smallpox vaccine anymore because we basically eradicated it from the earth. If we were able to do the same thing with measles we not may not need measles vaccine anymore. But unfortunately here’s the problem we got. We got measles in the world and not just in other countries but we’ve obviously got measles in the United States now. So it’s only a car ride or a bus ride or a plane ride away. And we’ve got unvaccinated populations. So it’s just a recipe. What we had here in Clark County is inevitable. And it will be inevitable in the future if we don’t get vaccination rates up. OK. If people want more information about measles work and they check. They can they can speak to their health care provider their physician they can call our health department as well. Yeah. And you have a Web site clark.wa.gov/public-health/measles-investigationYeah. It gives the latest information and your phone number 564-397-8403. That sounds correct. Well thank you very much and thank you for getting us through this. OK. Thank you.

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