Getting vaccinated can help stop measles from spreading
Calaveras County Health Officer Dean Kelaita said he believes the public “dodged a bullet” on measles transmission, but in Placer County, public health officials are investigating potential exposures to a family fighting three cases of measles.
Michael Romero, a public health official with Placer County, said the family is at home fighting off the deadly virus. He said they were exposed to measles while visiting someone in Butte County who had the illness and they did not know the individual had it.
Since returning to Placer County, someone in the family visited Auburn Racquet and Fitness Club from 7 to 9 p.m. on March 18, Romero said. Romero and his team are still working to identify people who were in the club at that time, determine their immunization status, and monitor those who could have contracted the measles. Romero declined to say whether the family had been vaccinated.
The Calaveras County girl, whose family lives in the Valley Springs area, was not vaccinated, Kelaita said, but his team has found no secondary cases of measles related to hers. She was diagnosed March 17 by physicians at Sacramento’s UC Davis Medical Center.
“This is a school-age child who had returned from overseas through San Francisco Airport, returned to our community and developed measles shortly after that,” said Kelaita, a physician specializing in family medicine. “She went to one of our local hospitals called Mark Twain Medical Center on March 14 and again on March 16, and she went to a neighboring hospital, which is called Sutter Amador Hospital in Jackson, which is the neighboring county, also on the 16th.”
The child’s parents took her to UCD Medical Center a day later when a rash appeared, Kelaita said, and she is recovering. After receiving the diagnosis, Kelaita said he pulled staff from other public health work they were doing to track down people who had come into contact with the child, figure out their immunization status and then monitor anyone who had not been immunized.
“We were able to generate a line list of over 40 people in our community that the child was exposed to,” Kelaita said. “We think we’ve been able to narrow it down to only a few critical contacts that weren’t immune, and now those people are being watched very closely for the development of measles, and so far, nothing has come up.”
Kelaita’s team also contacted public health teams in Amador, San Mateo and Santa Clara counties and at the state of California. He said state officials shared information with the airline and the U.S. Centers for Disease Control.
Vaccination is the only protection against the measles, doctors say, but there has been a surge in the number of people hesitant to be vaccinated or hesitant to have their children vaccinated. The World Health Organization recently listed the anti-vaccination, or anti-vax, movement as one of the top 10 public health threats.
The growth in the number of vaccine-hesitant U.S. residents has paralleled the explosion of posts by Russia-linked social media accounts stoking division on the safety of vaccines. Most of these accounts are programmed bots, researchers from Johns Hopkins, George Washington University and the University of Maryland found, and their posts prey upon parental fears.
Kelaita said: “I...hear people say, ‘Well, our immune symptoms know best, so getting these childhood diseases is a rite of passage for growing up like it was in the good ole days.’ Well, the good old days weren’t so good. Kids got polio, and they got paralyzed, and kids got meningitis and they died. The good ole days, back before the advent of vaccinations, were not the golden era of medicine.”
In an interview in February, California Public Health Officer Karen Smith said her staff had begun alerting doctors to be on the look out for measles. In a recent outbreak in Washington state, public health officials said it could cost as much as $1 million to stop the spread of the illness. In the end, 74 people were diagnosed with related cases in Washington and four in Oregon. Complications from measles infections can lead to deafness and death.
Smith said she was concerned because the sniffling, sore throat and itchy eyes of the measles can look like cold or flu, and since physicians rarely see measles cases, they are more likely to think a patient has flu because it’s flu season. Kelaita, who sent out his first provider alert on the measles on March 21, said that is likely what happened in this case.
“The doctor might say, ‘Well, you’ve got the flu. We’ve seen three or four people like this so far today,’” Kelaita said. “The doctors need to do a little bit more. They need to get a travel history. That’s pretty important. If the physician had asked, ‘Have you traveled in the past week.’ the parent might have said, ‘Yes, we just got off a flight from southeast Asia or the Middle East or Africa.’ That might change what you think it could be.”
An infected person can have measles for up to five days before showing symptoms, and it is transmitted by coughing the virus into the air or by touching moist, warm hands or surfaces where the virus can survive. Medical officials say that the virus aggressively attacks immune systems and that exposure to even a few droplets with the virus can make people sick.
Vaccines are not always compatible with everyone’s physiology, doctors say, so vaccines won’t always work on every child or adult who gets one. California law requires students to be vaccinated before entering school, but parents can request medical exemptions for their children.
Medical exemptions have more than tripled since Senate Bill 277 eliminated exemptions based on personal belief a few years ago, said Dr. Richard Pan, a pediatrician and state senator representing the Sacramento region.
“Some schools are reporting that more than 20 percent of their students have a medical exemption,” he said. “It is clear that a small number of physicians are monetizing their exemption-granting authority and profiting from the sale of medical exemptions.”
He and Assembly member Lorena Gonzalez, who represents the San Diego area, announced Tuesday they had introduced SB 276 to strengthen oversight of the medial exemption process because they say some doctors are selling medical exemptions to parents.
This bill would require that public health officers such as Kelaita and Smith approve medical exemptions, Pan said, and Kelaita said he supports that effort because some doctors are being too lenient. The California Medical Association and the American Academy of Pediatrics, California, trade groups that represent tens of thousands of doctors around the state, endorsed the measure along with a parent advocacy group called Vaccinate California.
“Examples like this (Calaveras measles case) show very clearly what happens when children aren’t vaccinated, and if we can continue to work with the public and impress upon them that vaccines are safe, they’re effective and they’re the greatest intervention in the history of public health to reduce these childhood diseases which, over time, have really wreaked havoc on the health of children for generations,” Kelaita said.