Measles: Public Health Emergency Declared in Anti-Vax Hotspot Near Portland

"Vaccine hesitancy" is giving preventable diseases a foothold.

The residents of Clark County, Washington are currently facing an outbreak of measles, a disease that, by all accounts, should no longer exist in the United States. The escalating measles outbreak in their community, spreading rapidly amongst un-immunized children, has been declared a public health emergency.

The outbreak worsened to emergency levels in a little over two weeks. On January 4, Clark County’s public health authority reported a single case of the measles. By January 15, it had confirmed two more cases and were investigating 11 possible new ones. On January 23, Clark County’s Council Chair Eileen Quiring declared a state of emergency when the number of confirmed cases spiked to 23.

This spread of this otherwise preventable disease is tragic, but sadly, not unprecedented or even unexpected. In June, scientists identified the Portland, Oregon area (just across the Columbia River from Clark County) as a potential outbreak hotspot due to high levels of unvaccinated kindergarteners.

And just this week, the World Health Organization announced that “vaccine hesitancy” — a reluctance to get vaccinated — is one of the leading threats to global health in 2019.

Back in June, scientists suggested that the Portland area could be at risk for an outbreak due to the levels of unvaccinated children. Now it's coming to fruition. 

PLOS Medicine 

The measles virus, which can lurk undetected for about two weeks, killed nearly 110,000 children worldwide, mostly under the age of five, in 2017.

These tragic deaths occur despite the fact that there’s a safe and 97 percent effective vaccine that protects against it. But, as the WHO has shown, hesitancy to use the vaccine in the US and beyond has already caused a resurgence in measles. Tarik Jasarevic, a spokesperson for the WHO, told PRI on Tuesday that failure to vaccinate can contribute to the “rise” of certain diseases, explaining that measles cases have increased 30 percent globally since 2016.

Immunization statistics from Clark County, Washington show that lack of immunization is directly related to the rise of measles in the own community. Citing state data, The Washington Post reports that almost seven percent of children in Clark County were exempt from vaccines in the 2017-2018 school year for personal or religious reasons. Of the 23 confirmed cases of measles in this outbreak, 20 of them are in unvaccinated individuals (18 of them in children under ten years old). The remaining three have “unverified” vaccination status.

Frustratingly, there were early signs that Clark County was at risk for an outbreak like this. The June 2018 PLOS Medicine paper pointed out that over 400 kindergarten students in that city were allowed to skip their vaccinations for religious or personal reasons, making it a “hotspot” for potential outbreaks.

Study author Peter J. Hotez, Ph.D., a professor at Baylor College of Medicine, doubled down on this fact in an interview with The Washington Post, adding that Portland’s vaccination rates are a “train wreck.” The paper listed several other cities that are also at risk: Austin and Fort Worth, Kansas City, Pittsburgh, and Detroit are all place where the number of non-medical exemptions to vaccinations could give diseases a foothold.

“This is something I’ve predicted for a while now,” Hotez told The Washington Post. “It’s really awful and really tragic and totally preventable.”

The measles threat is so dire that the World Health Organization thought it should be lumped together among other extreme dangers, like the Ebola virus and climate change. But, as Hotez attests, outbreaks like this are totally preventable, and the fact the WHO has vaccine hesitancy squarely in its crosshairs for 2019 is probably a good sign for the future.

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