A measles outbreak that has now infected at least 8 people in Philadelphia has been traced back to an unvaccinated child that contracted the virus while traveling abroad. Health officials are scrambling to contain the outbreak by offering free vaccines and tracking down hundreds of potentially exposed individuals. However, their efforts are being hampered by parents that are ignoring quarantine orders.
Unvaccinated Child Brings Measles Back from Foreign Travel
The measles outbreak first came to the attention of the Philadelphia Department of Health on January 4th, when an unvaccinated child developed a rash after returning from a trip overseas. The child had visited a country currently experiencing a large measles outbreak. Due to being unvaccinated, the child had no immunity when exposed abroad.
After returning to the United States, the child developed classic signs of measles including high fever, runny nose, red eyes, and rash. However, the child was still sent to a Philadelphia daycare center by parents that disregarded instructions to quarantine the sick child at home. This set off a chain of transmission that has so far resulted in 8 confirmed cases at locations throughout Philadelphia like schools, hospitals, and additional daycares.
Health Department Offers Free Vaccines, Expands Tracking Efforts
In response to identifying the index case of measles, Philadelphia Health Commissioner Cheryl Bettigole quickly assembled a team to coordinate vaccination clinics and contact tracing efforts.
”We are taking this outbreak extremely seriously and working to stop transmission of the measles virus,” said Bettigole. “But we need help from parents and community members.”
The health department is offering free MMR vaccines to uninsured adults and children at three clinic locations in Philadelphia. Over 250 vaccines were administered in the first two days alone.
Health officials have also greatly expanded contact tracing efforts to identify and track down individuals that were exposed to measles cases while contagious. As measles is one of the most contagious viruses, this has resulted in over 500 area residents identified as potentially infected. These individuals are being monitored for symptoms and asked to self-quarantine at home voluntarily.
Quarantine Breaches Hamper Outbreak Containment
Despite pleas from public health authorities, compliance with quarantine orders has been lacking. On January 17th, it was revealed that parents of the index case child had ignored instructions to isolate the sick child at home. Instead, the infected toddler was sent to a Philadelphia daycare center for several days, setting off a large exposure event involving staff and other children.
Several additional quarantine breaches have also been investigated, including instances of exposed hospital employees continuing to show up at work.
This table summarizes the quarantine breaches contributing to measles spread so far:
|Little Smilers Daycare
|Infected child sent to daycare by parents
|87 children, 12 staff
|Infected employee showed up for work shift
|142 patients, 45 staff
|Exposed radiology technician worked 2 shifts during quarantine period
Repeated quarantine violations are significantly limiting containment measures. Health Commissioner Bettigole expressed frustration over the situation:
“By ignoring quarantine orders, individuals are directly enabling measles to spread. We cannot allow personal inconvenience to trump public health.”
Measles Cases Expected to Increase
So far there have been 8 confirmed infections, but health experts anticipate many more in the coming weeks. Measles has an extremely long incubation period of up to 21 days. This means exposed people can spread the infection long before showing symptoms themselves.
“We are in a bit of a race against the clock to find additional cases before they have the chance to expose others,” explained Pennsylvania State Epidemiologist Sharon Watkins.
Of particular concern are several large exposure events that transpired at crowded locations:
- Over 2000 fans attended the January 10th Philadelphia Flyers hockey game at the same time as 2 contagious cases.
- On January 12th, a contagious hospital employee unknowingly infected hundreds of people while assignments in the maternity ward, including dozens of vulnerable newborn babies.
Given the substantial number of exposures, public health agencies are coordinating across state lines to prepare for finding additional measles cases. As of January 17th, potential exposures linked to the Philadelphia outbreak have been identified in 4 other states.
“We have confirmed that contagious individuals attended gatherings across Pennsylvania and even into Delaware. Measles does not respect borders or state lines,” said Delaware Division of Public Health Director Rick Hong.
Long Term Outlook Depends on Vaccination Rates
Looking beyond the current outbreak, health experts believe the Philadelphia area remains at increased risk for measles transmission going forward due to suboptimal vaccination rates and growing vaccine hesitancy.
In some Philadelphia zip codes, only 75% of kindergarten students have received the recommended 2 doses of the MMR vaccine. This is considerably below the 93-95% coverage scientists estimate is required for community-wide protection against measles infection.
To prevent future outbreaks, significant effort needs to be undertaken to address lingering anti-vaccine viewpoints and counter factual myths still circulating on social media. Otherwise, measles will continue to pose an unchecked and disruptive public health threat.
“We have to acknowledge that vaccines have become collateral damage from misinformation campaigns run amok on the internet,” said Philadelphia’s Health Commissioner. “Pushing back will require a coordinated response between public health agencies, doctors, parents and community leaders across all levels.”
While containing the current measles cluster remains the top priority, plans are already being formulated to bolster vaccination efforts and launch local educational programs after the outbreak concludes.
“Measles outbreaks should not be an inevitable consequence of dropping vaccine coverage,” stressed Bettigole. “With proper prevention strategies, adequate healthcare access, and community participation, even deadly infectious diseases can be controlled, and one day hopefully eliminated.”
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