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Portland: Measles Outbreak Grows

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    Posted: January 26 2019 at 7:41am
Measles outbreak grows in anti-vaccination hotspot near Portland

VANCOUVER, Wash. — The number of confirmed measles cases near Portland grew to 31 on Friday — an outbreak boosted by lower-than-normal vaccination rates in what has been called an anti-vaccination U.S. “hot spot.”

Public health officials in southwest Washington, just across the Columbia River from Portland, Oregon, said people may have been exposed to the dangerous disease at more than three dozen locations, including Portland International Airport, a Portland Trail Blazers game, an Amazon Locker location and stores such as Costco and Ikea.

Twenty-six of the confirmed patients had not been vaccinated against measles, and the vaccination status of four others who were infected is unknown. One child has been hospitalized. Authorities say nine additional cases are suspected.

One case also has been confirmed in King County, which is home to Seattle and one was confirmed Friday evening in Multnomah County, which is home to Portland.

Most of the cases involved children younger than 10, the Clark County Public Health Department said in a statement. One adult is infected, and the rest are teenagers. Oregon officials didn’t provide the age of the adult infected there.

Washington Gov. Jay Inslee, a Democrat, declared a statewide public health emergency for his state on Friday. Authorities in neighboring Oregon and Idaho have issued warnings.

Inslee said the number of cases “creates an extreme public health risk that may quickly spread to other counties.”

The measles vaccine has been part of routine childhood shots for decades, and measles was declared eliminated in the U.S. in 2000.

But measles is still a big problem in other parts of the world. Travelers infected abroad can bring the virus into the country and spread it, causing periodic outbreaks.

Last year, there were 17 outbreaks and about 350 cases of measles in the U.S.

Officials still are not sure where this Pacific Northwest outbreak began. The first known patient sought medical care on Dec. 31, but it is unknown if other people may have gotten sick before that and did not seek treatment. Public health officials are focused for now on preventing more exposures.

It could be weeks or even months before the “exquisitely contagious” virus runs its course in Washington, Dr. Alan Melnick, the Clark County health officer, said Friday.

People who choose not to vaccinate their children are underestimating the dangers of the illness, said Melnick, who himself had measles as a child, before the vaccine was commonplace.

Before the vaccine, 400 to 500 people died from the measles each year, 50,000 people were hospitalized and 4,000 people developed brain swelling that can cause deafness, he said. Between one and three cases out of every 1,000 are fatal, he said.

“It’s one of the most contagious viruses we have. It can have really serious complications … and it’s entirely preventable with an incredibly cheap and safe vaccine,” Melnick said.

Clark County has already spent more than $100,000 trying to contain the outbreak, and staff is being pulled from other duties, including restaurant inspections, he said.

“It’s all hands on deck. Clearly this is going to cost hundreds of thousands of dollars, and it wouldn’t surprise me if we were in the seven figures by the time we’re done here,” he said. “These costs could have been prevented if we had everybody vaccinated.”

Clark County, which includes the Portland bedroom community of Vancouver, Washington, has a measles vaccination rate of 78 percent, well below the 92 to 94 percent rate required for so-called “herd immunity,” said Marissa Armstrong, the department’s spokeswoman. Herd immunity happens when unvaccinated individuals are protected from infection because almost everyone around them has been vaccinated and is immune to a disease.

The measles vaccination rate for 2-year-olds in Multnomah County, home to Portland, was 87 percent in 2017, according to state data. The measles vaccine consists of two shots, one given by age 2 and the second usually between ages 4 and 6.

Data on Portland’s vaccination rate for both shots wasn’t immediately available.

Two doses of the vaccine in childhood are 97 percent effective and provide lifetime immunity. One dose is about 93 percent effective.

Both Washington and Oregon allow vaccine exemptions for personal and philosophical reasons. The vaccine-exemption rate in Clark County for non-medical reasons was high, at 7.5 percent, Armstrong said.

The incubation period for measles is seven to 21 days, which means that an unvaccinated person who has been exposed could be out in public for up to three weeks before getting sick. Patients remain contagious for four days after they develop the rash.

The virus, spread by coughing or sneezing, can remain in the air for up to two hours in an isolated space. Ninety percent of people exposed to measles who have not been vaccinated will get it, public health officials said.

Every time an unvaccinated person who has been exposed to measles goes out in public, “it starts that clock over again,” Armstrong said.

Earlier this week, authorities were successful in identifying several people who had been exposed but were not sick yet. Those people stayed home and later got ill, Armstrong said.

Those who may have been exposed should watch for early symptoms of fever and malaise and then a rash starting on the head and moving down the body. Serious complications such pneumonia and brain infections can arise from the disease in some cases.

Source:   https://nypost.com/2019/01/26/measles-outbreak-grows-near-portland-region-dubbed-anti-vaccination-hot-spot/
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Post Options Post Options   Thanks (0) Thanks(0)   Quote EdwinSm, Quote  Post ReplyReply Direct Link To This Post Posted: January 26 2019 at 10:34pm
These figure
Quote
Before the vaccine, 400 to 500 people died from the measles each year, 50,000 people were hospitalized and 4,000 people developed brain swelling that can cause deafness, he said. Between one and three cases out of every 1,000 are fatal, he said.
seem to confirm the CDC data [Note the brain swelling (encephalitis) only seems to produce severe complications in about 10% of the patients.]

Common Complications
Common measles complications include ear infections and diarrhea.
Ear infections occur in about one out of every 10 children with measles and can result in permanent hearing loss.

Diarrhea is reported in less than one out of 10 people with measles.

Severe Complications
Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die.

As many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children.

About one child out of every 1,000 who get measles will develop encephalitis (swelling of the brain) that can lead to convulsions and can leave the child deaf or with intellectual disability.
For every 1,000 children who get measles, one or two will die from it.
Measles may cause pregnant woman to give birth prematurely, or have a low-birth-weight baby.

https://www.cdc.gov/measles/about/complications.html
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[This is an outbreak update; also posted in General Discussion]

43 confirmed measles cases in Clark Co. outbreak, including child who had one MMR vaccine

by KATU Staff

Saturday, February 2nd 2019

A measles outbreak near Portland has sickened dozens of people in Oregon and Washington, with several more cases suspected, and public health officials scrambling to contain the virus say low vaccination rates are making the situation worse. Clark County Public Health said Sunday, Jan. 28, 2019, that the majority of the cases involve children younger than 10.

VANCOUVER, Wash. –Health officials say there are now 43 confirmed cases of measles in the Clark County outbreak, including one person who had one dose of the MMR vaccine.

Authorities say they are also looking at 8 suspected cases of the virus.

Clark County Public Health said most of the patients are children under 10 years old, ten cases involve kids ages 11 to 18 and one case is in an adult between the ages of 19 and 29.

Of the cases, 37 people were not immunized and five cases are not verified to have had the vaccine. One of the patients received one of the two doses of the MMR vaccine.

The CDC says one dose of the MMR vaccine is 93 percent effective, while having two doses of the vaccine is 97 percent effective.

Children typically receive the first MMR vaccine at one year to 15 months old, and the second dose from 4 to 6 years of age.

The patients visited several public places while contagious - including the Portland International Airport and Moda Center - and could have exposed thousands of other people to the virus. | FULL LIST OF EXPOSURE SITES: https://www.clark.wa.gov/public-health/measles-investigation

"Measles can be so contagious that you can be in a room, and if you’re susceptible, two hours after someone with measles left, and still get the disease," said Dr. Alan Melnick, the director of public health for Clark County.

Measles symptoms begin with a mild fever, cough, runny nose and red eyes, followed by a rash.

If you or your child went to one of the possible exposure sites and show signs of measles, call your health care provider before coming in so they can limit exposing anyone else in the waiting room.


Oregon residents can visit the Oregon Health Authority website to find out if they're vaccinated.

"Most people are immunized, but again measles does have a way of finding people who aren’t. It’s the most contagious human disease we know about," Dr. Paul Lewis with Multnomah County Health said.

Dr. Lewis says if you have a child under the age of 1 that you are concerned about, you can talk to your healthcare provider about getting the vaccine early. You should also check with any daycare your child attends to make sure they require their workers to be up to date on immunizations.

If you have any further questions about the measles, call your local health department:

    Clark County Public Health: (360) 397-8021
    Clackamas County Public Health: (503) 655-8411
    Multnomah County Public Health: (503) 988-3406
    Washington County Public Health: (503) 846-3594

Source, photos and a list of symptoms of the virus:   https://katu.com/news/local/43-confirmed-cases-of-measles-in-clark-co-outbreak-including-patient-who-had-mmr-vaccine
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[In a nutshell:]

Measles outbreak in southwestern Washington rises to 50 cases
State health officials are urging vaccinations and discouraging the use of vitamin A, which will not cure or prevent measles


[In depth:]

Feb. 4, 2019, 10:20 PM GMT
By Shamard Charles, M.D.

An outbreak of measles in southwestern Washington is growing worse by the day, with the number of cases soaring to 50 as of Monday, according to state health officials.

Clark County health officials have confirmed 49 cases there since Jan. 1. On Jan. 23, one case was confirmed in King County, home to the state's largest city, Seattle. It is not clear where the King County patient became infected, but he did report having traveled to Vancouver, the seat of Clark County, before his diagnosis, health officials have said.

As with a similar outbreak among Orthodox Jews in New York state, nearly all of the infected were unvaccinated. Clark County reported that 42 of the 49 patients had not been vaccinated against measles. One patient had received only one of the two recommended doses of the vaccine, and the vaccination status of six others was unknown, the county department of health said.

People may have been exposed to the dangerous disease at more than three dozen locations, many in neighboring Oregon, such as Portland International Airport and the Moda Center, home to the Portland Trail Blazers. Other possible infection sites in Portland include an Amazon Locker location and stores such as Costco and Ikea.

On Jan. 22, Clark County health officials declared a public health emergency.

Dr. Scott Lindquist, a Washington state epidemiologist, said the state health department is seeing new cases every day. "This is entirely preventable," he said in a statement to NBC News.

He advised families to check their immunization records. "If you are concerned your child may be developing measles, call your provider before going to a medical facility in an effort to prevent the spread of measles to vulnerable people within these facilities," he added.

Anti-vaccination hot spots have been developing for several years. Along with Washington and New York, at least seven other states — Hawaii, Oregon, Pennsylvania, Connecticut, Colorado, California and Georgia — have reported measles cases this year.

Reports that some people are self-medicating with vitamin A have also surfaced, leading the Washington State Department of Health to warn in a tweet that vitamin A has no effect on measles and that “the only way to avoid getting measles is to be vaccinated against it.”

Children who are deficient in vitamin A are at higher risk for severe complications from measles if they get the disease, but most children in the U.S. receive sufficient amounts in their diet. In the rare case of deficiency, vitamin A can be used to prevent severe complications of measles, including blindness and death.

Source and tweets:   https://www.nbcnews.com/storyline/measles-outbreak/measles-outbreak-southwestern-washington-rises-50-cases-n966751
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