County health officials warn measles outbreak far from over

The county’s Public Health Officer says it could be months before this is over, and the bill to the county could reach hundreds of thousands of dollars

VANCOUVER — The measles outbreak hitting Clark County is likely to run up a massive bill, and drag on for at least the next several weeks. That was one takeaway from comments made by Clark County Public Health Officer Dr. Alan Melnick at a meeting of the Board of Health Wednesday morning.

Melnick said the cost of the response to the measles outbreak in just the first few days was $31,000.

“This is going to be likely hundreds of thousands of dollars, if not more,” he told the board.

Over the weekend Clark County Chair Eileen Quiring approved a public health emergency declaration, which will allow the county to tap into federal resources to address the crisis.

“Right now we’re looking at bringing in a level three incident management team to help us manage this outbreak,” said Melnick, adding that it has been especially taxing as a late-blooming flu season has taken off in recent weeks.

“While our staff are in incident command working on measles, the other communicable diseases don’t suddenly stop,” Melnick said.

The latest numbers from Clark County Public Health showed two new confirmed measles cases, with the number growing to 25, and there are now 12 suspected cases. Nineteen of the confirmed cases are in children from 1 to 10 years old, five are in people age 11 to 18, and one is an adult. Melnick says they haven’t been able to confirm whether four of the cases were immunized, but all the rest did not have vaccinations.

“All of those cases could’ve been prevented by a very effective, an incredibly safe, and a very cheap vaccine,” said Melnick, calling it “tragic” that the county has such a high rate of unvaccinated people.

Melnick said he knows a lot of criticism has been leveled at local religious communities online, alleging that they are using their beliefs in order to allow their children to attend school without immunizations.

“The religious exemptions are really rare,” he said. “The vast majority of exemptions are what we call personal or philosophic exemptions.”

Until a few years ago, Melnick said most of those exemptions were last minute ones from parents who had neglected to make sure their student was current on their vaccinations. Under a state law passed several years ago, parents now have to provide proof that they’ve spoken with their child’s doctor and been educated on the risks of not having current vaccinations before they are allowed to claim a personal of philosophic exemption. Around 1 percent of students are exempted for medical reasons.

While that requirement has likely helped reduce the number of unvaccinated students, Melnick admits Clark County still has a disturbingly high rate of exclusions.

At many Clark County schools, rates of unvaccinated students were as high as 10 percent. For River HomeLink in Battle Ground, the state Department of Health says 23.5 percent of students had not received the MMR vaccine. County-wide, the state estimates the vaccination rate may be as low as 71 percent.

Students and staff from schools identified as possible exposure sites that don’t have proof of current immunizations against measles have been excluded from all schools within the county for at least the next couple of weeks. If more cases pop up, Melnick says those exclusions could be extended further.

The first case of measles was noted on Jan. 1. That means we’re in what Melnick calls the third or fourth generation of the outbreak.

“It’s very possible that we’ll be seeing cases outside of Clark County,” he said, “including other spots in Washington as well as our neighbors to the south.”

That statement came just a few hours before health officials in King County said they were investigating a suspected measles case there. The man, in his 50’s, had been hospitalized but then released. Officials said he had recently traveled to Southwest Washington, but it’s currently unknown if that is where he was potentially exposed to measles.

The outbreak has impacted at least eight health facilities, and 11 schools. People attending the Trail Blazers game at the Moda Center on Jan. 11 may have also been exposed, along with several other businesses in Vancouver and Portland, including Ikea on Jan. 11.

Given the number of potential exposure locations, and the time it takes for the virus to show symptoms, Melnick says it’s likely that this outbreak will drag on quite a bit longer.

“It’s a good possibility that we’ll be dealing with measles, in continuing numbers, and perhaps even increasing numbers, over the next few weeks and months,” he told the board.

The virus is exceptionally contagious, and can be spread through a cough or sneeze, lingering in the air up to two hours after the infected person has left. Melnick says unvaccinated people have a 90 percent chance of being infected if they come into contact with the virus.

Further complicating the issue, says Melnick, is that the early signs of measles are similar to other viruses common this time of year.

“Your symptoms are runny nose, fever, cough, pinkeye,” he says. “Well that’s fairly common this time of year, and if you haven’t been immunized there’s no way to know whether that’s measles or something else. When you get those symptoms you’re incredibly contagious and you don’t know if you have measles yet. The only way to know that you don’t have measles is to be vaccinated.”

Melnick says if you think you have been exposed, you have only 72 hours to receive a vaccination shot in order for it to potentially be effective. There are more effective immunoglobulin treatments available, but those are in limited supply and being reserved for younger children who might be at greater risk from the disease.

Combating social media

Melnick admitted it has, at times, been an uphill battle when it comes to fighting the spread of what he called misinformation about the measles vaccine online, especially through social media.

“Some of it is very sophisticated looking, and very well done,” he said. “The link between vaccination and autism has been debunked, a long time ago. There’s also misinformation going on about shedding the vaccine virus and causing other people to get infected. That’s also been debunked.”

Quiring pointed out that she can understand how concerns about the potential health risks of vaccines get so many people convinced, despite scientific evidence to the contrary.

“Sometimes when something is stated over, and over, and over, it somehow becomes the truth,” Quiring said.

Melnick said his department is seeking state funding support for fundamental health services, especially ways to help prevent outbreaks like this. The board of health passed a resolution Wednesday supporting that effort.

Meanwhile Melnick said that, once this crisis has passed, he would like to look into ways to better combat misinformation online, both through their own social media channels, but also through schools and health offices.

“I would really love to work closely with the schools when this is over with, not only to help them prepare for an outbreak, but also to develop some better data tracking of the kids,” said Melnick, “as well as some education and outreach to the parents more about this. And this may be the impetece, unfortunately, that helps that happen.”

Newly sworn-in District 4 Councilor Gary Medvigy said on Tuesday he would be in favor of looking at whether current measles vaccinations could be made a requirement for some jobs, especially for people who would be working around children or vulnerable populations.

For more information on the outbreak, and an updated list of possible exposure sites and times, visit the county’s website here:

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