Measles outbreak prompts hundreds on Peninsula to take their best shot

Graphic by The New York Times News Service ()

Graphic by The New York Times News Service ()

Measles: It’s the rash that sparked the rush for shots on the North Olympic Peninsula.

More than 1,000 in Clallam County from December through February were vaccinated with the measles, mumps and rubella (MMR) vaccine — and for many, varicella, too (MMR/V) — after the first of five measles cases in the county was reported Feb. 1.

An additional 151 people were vaccinated in Jefferson County, where no measles cases were confirmed this winter, during the same period. March figures are not available yet.

Vaccinations should be all the rage, say public health officials on the North Olympic Peninsula.

They blame last winter’s measles outbreak on people’s unwillingness to immunize themselves or their school-age children.

“I would like to see the number even higher,” said Dr. Tom Locke, public health officer for Jefferson County and formerly also the health officer for Clallam County.

Figures for 2014 from the state Department of Health showed that 56 percent of students in Jefferson and 89 percent in Clallam were fully immunized against so-called childhood diseases.

A minimum of 90 percent is considered the threshold to prevent a disease from spreading widely, according to the U.S. Department of Health and Human Services.

Unless a new case is reported, the current measles threat won’t end officially for another two weeks.

April 19 is when two full periods of possible contagion will expire after the last reported case, foreclosing the possibility that another measles carrier remains to be discovered.

All of Clallam’s cases were connected to the first confirmed case in the county: a 52-year-old Port Angeles man who was hospitalized with measles and other health issues at Olympic Medical Center. He recovered.

The last case diagnosed was March 4 in a man who had received a vaccine that hadn’t been administered in 44 years.

He quarantined himself, health officials said, and was unlikely to spread the highly infectious viral disease.

In all, two juveniles and three adults were diagnosed with measles.

A 43-year-old man and a 5-year-old girl caught measles after exposure to the man who came down with the first case.

A 14-year-old sibling of the kindergarten girl contracted measles after exposure to her.

The fifth patient was a relative of two of the others.

Clallam County has had five of the seven measles cases reported in Washington state.

The immunization figures represent only vaccine that was distributed by the state Department of Health, which provides vaccine for all children in Washington.

The numbers don’t include shots that were purchased privately, Locke said.

In Clallam County, MMR and MMR/V children’s vaccinations totaled 229 for December 2013 and January-February 2014. In December 2014 and January and February 2015, they shot up to 952.

Another 329 doses were given to adults at county clinics.

Even the figure of 952 injections represents a 316 percent increase, but Iva Burks, director of Clallam Health and Human Services, said the numbers are relatively low.

“If this were King County, it would be pretty significant, but we were pushing it,” Burks said, referring to the special no-cost measles vaccination clinics the county held during the outbreak.

As for King County, the state health department reported a 20 percent hike in measles vaccinations for children. Snohomish County logged a 19 percent increase.

Overall, Washington vaccinated about 28 percent more children over early 2014.

Despite the rise in vaccinations, state legislators turned back an effort to close the exemption for “personal” reasons that parents may cite to avoid having their children immunized.

The final tally isn’t in yet, but Locke has said the costs of containing the outbreak could be as high as $200,000.

The raw cost of the outbreak — measured as the increase in vaccinations over the preceding year and multiplied by the $110 cost of each shot — totals nearly $80,000.

That doesn’t count the overtime put in by Health and Human Services workers or the cost of work that was set aside during the outbreak and remains to be done.

Then there’s the extra work put in by private providers, school nurses and other health care workers who reviewed their records and urged parents of unvaccinated or undervaccinated children to get them immunized, said Dr. Jeanette Stehr-Green, interim Clallam County public health officer.

One shot provides about 90 percent immunity from measles. A second dose boosts immunity to at least 97 percent.

As for unvaccinated people, nine in 10 probably will catch measles, health experts say, if they are exposed to the airborne virus that can linger in the air for two hours after an infected person has sneezed or coughed.

Stehr-Green said, “I knew that they [private providers] were doing a lot, and they stepped up to the plate.”

The diagnosis of the first measles case was made by an alert OMC emergency room doctor who’d never seen the disease, according to the hospital.

From there, Health and Human Services workers tracked that patient around Puget Sound and the Peninsula, contacting more than 200 people and confirming measles in two children, later in two more adults, who’d had contact with the man.

The investigative effort and the immunization campaign that followed it stopped the highly contagious virus from spreading exponentially, Stehr-Green said.

“I think that we responded just admirably,” she said.

As for Burks, she hopes the outbreak is over.

“We’re just crossing our fingers,” she said, “and waiting for the 19th [of April].”

_______

Reporter James Casey can be reached at 360-452-2345, ext. 5074, or at jcasey@peninsuladailynews.com

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