8/21/14 Measles outbreak tested health officials ability to respond to crisis

  • By Nick Sabo
  • August 21, 2014
  • 411
                        
SUMMARY: With measles outbreak apparently over, Holmes County Health Commissioner says response of health officials justifies the presence of public health The recent measles outbreak has shown a justification for public health, according to Holmes County’s top health official. The measles outbreak that affected nine counties is one for the U.S. record books. With 377 confirmed cases, it is the largest measles outbreak in the country since 1994 and the most serious since the disease was declared eradicated in 2000. Holmes County, in the midst of the firestorm, had 64 confirmed cases, the second largest number next to Knox County, where the outbreak began. The outbreak gained national attention. Holmes County Health Commissioner Dr. D.J. McFadden said health officials’ day to day experiences with epidemiology helped prepare them for the outbreak. “Our job is not just to stop but to detect,” McFadden said. “We approached the measles the same as every other disease that comes our way, just on a larger scale. Every day we get a call and investigate, and quietly close the book.” According to the Ohio Department of Health, the outbreak began March 23 when a Knox County woman began showing symptoms of the disease. The outbreak spread to nine counties, with Ashland, Coshocton, Holmes, Knox, Richland and Stark counties reporting multiple confirmed cases. Crawford, Highland, and Wayne County each had one case. The cases in Knox and Holmes were mostly among the local Amish population. Knox County, the epicenter of the outbreak, would go on to hit 195 cases. From the first reported case, local departments of health were put on alert and began fighting the outbreak with vaccination and identification, asking persons exposed to the disease or infected to self-quarantine. McFadden was notified that the outbreak could have swept into Holmes County April 21. The Knox County woman had gotten measles after being exposed to the disease on a mission trip in the Philliphines. The families of the those who returned from the trip were acquainted with Holmes County families as well. “I got the call on April 21 at 4 p.m. that measles could be in Holmes County,” McFadden said. “Efforts began immediately.” The Holmes County Health District held its first mass measles, mumps rubella (MMR) vaccine clinic April 25, and went on to hold as many as three per week. Three months later, health officials in the affected area had administered 10,000 doses of MMR, more than 5,000 of them in Holmes County. The Holmes County Health District’s first order of business for weeks was the measles. McFadden reported that his staff was taking as many as 200 calls per day, fielding questions about measles and the outbreak. The county’s medical reserve corps was activated, drawing on its reserve of nurses and doctors who could administer the vaccine. The Centers for Disease Control (CDC) dispatched specialists to the area to help identify cases. In both Knox and Holmes, vaccination efforts ran into the prevalent belief that it is better to be exposed to measles and acquire a natural immunity than be exposed to the risks of the vaccine. In Knox County, reports of so-called “measles parties” surfaced, where unvaccinated families would visit families who had the disease, in a deliberate attempt to contract measles. Those who took ill included babies on up to the middle-aged. In its summary of the outbreak as of Aug. 21, the ODH reports that the “cases range from under six months to 53 years...There have been some hospitalizations reported; most have recovered on their own”. A total of nine persons were hospitalized, including a Holmes County child who was treated at Akron Children’s Hospital. The child has since recovered, McFadden said. For McFadden, the outbreak answered a very important question about attitudes toward public health. “The mainstream attitude in the nation right now is, do what is right for you,” McFadden said. “While I know Holmes County tends to look at what’s best for the whole community, I know that what we ask are very hard things, we are asking a lot. It has been a lingering question for me, what will people do. “If folks had not vaccinated as quick as they did, if they had not quarantined, it would be a very different story,” McFadden said. The outbreak was a further validation of what public health does, McFadden said. Had there not been the infrastructure in place, with a ready body of professions on hand to respond, the outbreak could have spiraled out of control. “This is why we have those decades of ground work, so that it is there when a crisis happens,” McFadden said. The last individual to come down with measles began showing symptoms July 23. Though no cases have been reported since then, health officials are waiting 42 days before declaring the outbreak over. The 42 days represent two, 21 day periods that represents a new wave of measles, from the time a patient begins showing symptoms and passes on the disease to others.


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