Washington Public Health Official Discusses Measles Outbreak In Pacific Northwest

NPR's Ari Shapiro talks with Dr. Alan Melnick, director of public health for Clark County, Wash., about the measles outbreak in the Pacific Northwest. Clark County now has 50 confirmed cases.

ARI SHAPIRO, HOST:

In Washington state, the governor has declared a state of emergency over a measles outbreak. This disease was declared eliminated from the U.S. in 2000 thanks to widespread vaccination campaigns. Yet right now, the Centers for Disease Control and Prevention is tracking three measles outbreaks, including the one in Washington state. Most of the people infected are children who were not vaccinated. And to talk with us about this, Dr. Alan Melnick joins us from Clark County, Wash., where he's director of public health. This county is just over the state line from Portland, Ore.

Welcome to ALL THINGS CONSIDERED.

ALAN MELNICK: Thank you.

SHAPIRO: Your county has about 50 confirmed measles cases, and Washington state has one of the lowest vaccination rates in the U.S. Are parents to blame for this outbreak?

MELNICK: Well, I don't want to point the finger at anybody. I think there's a lot of misinformation going on on social media and elsewhere that looks pretty sophisticated. And I think some parents who are otherwise well-meaning are scared, and they don't know what to do. And some of them choose not to vaccinate their kids.

SHAPIRO: But bottom line, this problem was preventable.

MELNICK: This problem was 100 percent preventable. What we're seeing here does not need to be happening. We should have eradicated measles not only from the United States but from the world by now.

SHAPIRO: Tell us about how dangerous it is. I know it's highly contagious.

MELNICK: It is not a benign disease. Before we had routine vaccination in the United States, we had 400, 500 deaths from measles every year. There were close to 50,000 hospitalizations every year in the United States for measles. And we had about 4,000 people who had measles encephalitis, which is a swelling of the brain that can lead to permanent damage, including deafness. If you're susceptible and you haven't been vaccinated, you can be in a room two hours after somebody with measles left and still get the disease. And one person with measles will infect 90 percent of the folks who are susceptible around them.

SHAPIRO: Ninety percent, wow.

MELNICK: Ninety percent of them will become ill.

SHAPIRO: There is now a list of public exposure locations in Clark County that your department has put out. That list includes doctors' offices, schools, day cares, churches, a Trader Joe's, a WalMart. Are you saying any unvaccinated people who are at those places during a particular window of time could have become infected?

MELNICK: Yes. We even had an exposure at the Moda Center, where the Portland Trail Blazers play. So you know, that's an arena of around 20,000 people. So depending on where the exposure site is, we have to take some precautions.

So if the exposure is in a doctor's office or an emergency department - and we're particularly concerned there because the people most at risk of getting measles are infants who are too young to be vaccinated, people with immune suppression who you might run into in an emergency room or a doctor's office and pregnant women who haven't been vaccinated. So if we have a case that's been in a doctor's office or emergency department, we actually have to work with the clinic or the emergency room to find out who was in the emergency room or clinic for up to two hours after that person with measles left. We have to determine whether they're unvaccinated. And if they are, we have to put them on active monitoring. We also have to ask them if they brought anybody with them that wasn't on the patient roster, and we have to contact them and interview them.

So the point I'm making is that there's a lot of work that goes into this in terms of protecting the public.

SHAPIRO: I know you're trying to be measured in your response, but the governor has declared a state of emergency. The measures that you are describing sound extreme. What does it feel like to be at the center of this?

MELNICK: As you can imagine, people are working around the clock. I mean, at one point, I'd spoken to a nurse who'd worked 12 days straight. So we're getting help from other jurisdictions, but it's pretty frenetic. It's basically kind of an all-hands-on-deck situation here.

SHAPIRO: Could I ask you to just speak for a moment to parents in the United States who have not vaccinated their children? What is your message to them?

MELNICK: I have a couple of messages to them. One message is, regardless of what you hear on some of the social media sites, the vaccine is safe, effective, and it's inexpensive. I think the other thing I'd say based on our experiences here is we really need to think about putting a cocoon around other people who are around us.

In Clark County here, we've already had to identify immunoglobulin for a number of infants who were exposed. They were too young to be immunized. I'm hoping the immunoglobulin works. It's not the first choice, but it's the only thing we have. So vaccinate your kids not only to protect them but to protect everybody else around them.

SHAPIRO: Dr. Alan Melnick, director of public health in Clark County, Wash., where there is a measles outbreak, thank you very much for talking with us.

MELNICK: Thank you, Ari.

(SOUNDBITE OF HOT SUGAR'S "THE TREMBLING HAND")

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