Wisconsin health officials are reporting an increase in measles cases, with 158 confirmed and six probable infections in the outbreak across Iowa, Lafayette, Grant and Vernon counties. The Wisconsin Department of Health Services announced two new cases in Vernon County on Wednesday, including one involving a person visiting the county from out of state. Health teams are investigating whether the new infections are connected to the ongoing outbreak in other counties.
Vernon County had a vaccination rate of only 42 percent for two-year-olds last year, far below the state average, according to Wisconsin Public Radio. Lafayette County and Grant County also had low MMR vaccination rates, at 60 and 64 percent respectively. Iowa County’s rate was 81 percent.
Dr. Ryan Westergaard, the Chief Medical Officer for Communicable Diseases at DHS, said low vaccination levels help explain how the virus spread so quickly. He added that individuals can still reduce their risk by isolating themselves and getting vaccinated after exposure.
DHS Immunization Program Manager Stephanie Schauer said local health departments are seeing more interest in vaccines from people who had not been vaccinated before. Some local health departments are planning to offer vaccines at schools and are working with school nurses to check immunization records.
Although the MMR vaccine is required for public school attendance in Wisconsin, children can still attend if their parents claim religious or personal belief waivers. Southwestern Wisconsin has several Amish and Mennonite communities where use of preventive health care tends to be lower. Public health teams are reaching out to these households proactively to provide vaccine access and reduce exposure risks.
Westergaard said the new cases in Vernon County make it difficult to predict how long the outbreak will continue. Federal support from the Centers for Disease Control and Prevention through the Epi-Aid program helped Wisconsin officials investigate exposures in August, but those additional resources have ended.
Westergaard said officials hope they can contain the new activity without wider person-to-person spread. One case of measles related to out-of-state travel was also reported in Marathon County. DHS said the Marathon County case is not connected to the southwest Wisconsin outbreak.
Wisconsin has now reported 167 confirmed measles cases this year. The southwest outbreak includes another six probable cases that are not included in that confirmed statewide total. More than half of the cases reported earlier in the week involved children and adolescents and five people had been hospitalized.
Pennsylvania is also seeing a rise in measles cases, with 36 new infections reported since Wednesday across 38 counties, according to a report from WGAL. Montgomery County reported its first cases this year, and Lancaster County continues to be a major hotspot with 16 new cases.
So far this year, Pennsylvania has reported 767 measles cases and four measles-associated deaths. The CDC has not included those four deaths on its national dashboard. Pennsylvania has tied its request for CDC Epi-Aid assistance to federal recognition of the deaths.
The disagreement centers on how the deaths should be classified. Pennsylvania health officials have confirmed four measles-associated deaths while federal officials have questioned whether all of the deaths should be included in the national measles total. Reuters reported that Pennsylvania Health Secretary Dr. Debra Bogen said the state could withdraw its Epi-Aid request if the CDC does not publicly recognize the deaths.
The Pennsylvania Department of Health reported 731 cases as of September 16. That number had risen to 767 by September 18. More than 99 percent of cases in the outbreak had occurred among people who were not fully vaccinated as of earlier September reporting.
A possible exposure was reported at Children’s Hospital of Philadelphia last week. The exposure happened on a Friday and involved various times throughout the day.
Health officials are working to ensure that infants in the hospital’s neonatal intensive care unit receive a preventive antibody product to reduce the risk of measles infection.
Measles is highly contagious and spreads through the air when an infected person breathes, coughs or sneezes. The virus can remain infectious in the air for up to two hours after an infected person leaves an area. Two doses of the MMR vaccine are about 97 percent effective at preventing measles.
The outbreaks in Wisconsin and Pennsylvania come during a broader national rise in measles. The CDC reported 3,471 confirmed cases nationwide as of September 17. Cases had been reported in 47 jurisdictions.
IMAGE: Pete Lewis / UK Department for International Development (DFID) CC2