Measles cases climb to 6 in South Dakota

South Dakota health officials Wednesday reported five additional cases of measles, a day after identifying the state's first case in almost two decades.

The South Dakota Department of Health identified three adults and two teens as the most recent recipients of the viral disease. That follows Tuesday's announcement that a child younger than 5 was the first case in South Dakota since 1997. All of the cases are in Davison County.

None of those infected have been vaccinated, and they are all members of the same extended family.

"This is a big event in public health," state epidemiologist Lon Kightlinger said.

An extended family gathering for the holidays allowed the virus to pass between the family members, Kightlinger said. Davison County is west of Sioux Falls and includes the city of Mitchell.

Several people are ill and are being tested, while others who have been exposed are being watched for symptoms.

"This isn't finished by a long shot," Kightlinger said.

One of the confirmed cases is a visitor from out of state, and while Kightlinger said the state can't force a patient stay in South Dakota, the person was still in Davison County.

Doctors and nurses have been vaccinating those exposed for the past two days at the Mitchell Community Health Office.

"Even though the state is highly vaccinated, we're still at risk for an outbreak," Kightlinger said.

Jennifer Schriever has been a family medicine physician at the Sanford Clinic for seven years and wasn't too surprised when she heard of the measles cases.

"Enough new people are refusing immunizations that I almost expected it," she said. "I hoped not for a long time because I know overall we have pretty good vaccination rates, but there certainly are some people in the community that choose not to immunize."

Schriever has a child in high school and said it's unfortunate when people choose not to vaccinate.

"We don't have much fear of (measles) anymore because it's uncommon," she said. "But it (not vaccinating) puts others at risk."

Kightlinger thinks the virus was brought from out of state considering the state's record with the MMR vaccine has been good.

"We eliminated measles from South Dakota for 18 years," he said. "Before that, it took its toll."

Although the highly contagious viral disease is on the rise, Kightlinger thinks people are fairly well protected in South Dakota with vaccination rate above 90 percent.

The best protection against the disease is the measles vaccine, MMR, which is given in two doses, the first at 12 months and the second by age four.

"There is lifelong protection against this disease with the vaccine," Kightlinger said.

In 2013, 93 percent of 2-year-olds in the state had one MMR shot, 97.9 percent of kindergarten-age children had both MMR shots and 94 percent of adolescents ages 13 to 17 had both MMR shots, Kightlinger said.

"Our goal is over 90 percent, but there are pockets of unvaccinated individuals who are susceptible to the disease," he said.

The measles cases in Davison County are the first in South Dakota since 1997, but they are some of the last reported cases this year on a national level.

Kightlinger said 610 measles cases had been reported through the end of November.

Linda Ross, CEO of Community Healthcare Association of the Dakotas, said the news of the measles case came as a surprise.

"You never really want to hear anything like this," Ross said. "This is something that can be prevented and wouldn't be the case if there had been vaccinations."

Ross said people should be alert and diligent when it comes to vaccinations.

"This shows how quickly it can spread," she said. "Sometimes we forget these diseases still exist because our vaccinations have kept them at bay."

From a preventative standpoint, Ross thinks parents should be taking their kids in.

"As you have an influx of people coming into the state, and especially Sioux Falls, it's important to children's education and good health," she said.

Considering the contagious nature of the disease, Schriever said it's possible to have spread outside of Davison County.

"These viruses tend to be contagious before they start to show symptoms, which means it could spread from outside of the community already," she said.

Kightlinger thinks there will be more cases in Davison County and the Department of Health has asked physicians and nurses to put measles high on their diagnostic ladder.

"This is an airborne disease that can linger for two hours after the effected person leaves the room," he said. "That fact tamps down our optimism. There are a lot of people we are checking on and that list grows by the hour."

Measles is an acute, highly contagious disease capable of producing epidemics.

Symptoms: The first stage may include a runny nose, cough and fever. The second stage begins between days three and seven and includes a high fever and a red, blotchy rash the spreads from the face to the entire body. Measles has a 21-day incubation rate with symptoms appearing in 10-12 days, or as early as 8 days and as late as 13 days.

Spreading: An individual is contagious seven days prior to the appearance of the rash and until four days after the rash is gone. The disease is spread by direct contact as well as airborne transmission

Source: South Dakota Department of Health