59 news measles case in Minnesota

Well, Minnesota reported 59 new confirmed measles cases this week with the state reporting 139 total cases since mid September. Wisconsin also facing an ongoing measles outbreak in the southwestern part of the state with the health department just yesterday reporting the death of an infant. Wow, Patsy Stinchfield is the executive director of Measles Collaborative and she joins us now. Patsy, thanks for coming on the show. Thanks for having me. Okay, so measles were declared eliminated in the United States in 2000. 26 years later, what is happening? That is such a good question. So we are seeing measles across the country, 45 states with cases right now. Minnesota and Wisconsin seeing these large numbers of cases. And it really is down to one simple thing. Not enough people are immune to measles. Not enough people have had their two doses of MMR vaccine. We really need to step that up. So is it vaccine hesitancy that is leading to these outbreaks? You know Courtney, it's a lot of different things. So Pennsylvania, for example, is burning up in the Amish community with measles. They don't have any religious reason or vaccine hesitancy. They're certainly not on social media getting disinformation sent to them. They just make decisions medically for their community to have little medical intervention. So that's their issue. But there are other people who are listening to disinformation on social media about the fears of MMR vaccine. And I have to say MMR vaccine is the safest and most effective vaccine that we have. Two doses getting us 97% coverage lasting a lifetime and very, very rare side effects to it. So I think I think there's lots of reasons. And these are spreading state to state. These are not imported from other countries. This is a US measles outbreak like we haven't seen since the 1990s when I first started as a nurse practitioner at Children's and we turned a whole ward into measles cases. We do not wanna go back to that. 45,000 people died from the flu last year, only eight died from measles. So why should we be ringing the alarm bells so loudly? Well, we wanna ring the alarm bells about both of those diseases because we can prevent both of those with a vaccine. Everyone right now should be getting their flu and COVID RSV vaccines. The thing about measles, though, is it's like the tornado siren of infectious diseases. When you start to see this, it is the most contagious virus on Earth. It spreads very easily just by me talking in a room. If I were infectious and there were 10 people in the room, the nine people out of those 10 would get it if they weren't immune. So how easy it is to spread, how contagious it is, and the number of cases. With each case they will go on to infect another 12 to 18 cases. So it's like this spiderweb of infection that happens really quickly, much more easily than influenza or COVID. But you can only infect somebody who isn't vaccinated, right? It's my understanding that if you are vaccinated for measles, you are fully protected. So it's only the unvaccinated who are at risk. You are right, Courtney. So that is what our message is, is if you've had your two doses of MMR vaccine or if you're older, born in 1957, in your 60s, 70s or older, you're protected. You have immunity. It's the people that have not had their vaccines that we're concerned about. This virus is so stealth. It will find, that's how it replicates and survives is it finds people who are not immune and goes into your lymph nodes and replicates and makes that person very sick and another person very sick and so making sure that those who can get vaccinated vaccinate for themselves but remember our population will always have people vulnerable to measles babies too young to be vaccinated. Those who are undergoing chemotherapy, those with primary or secondary immune deficiencies. So look around and see those people in the grocery store and know that when you've vaccinated yourself, you did a good job for yourself and your family, but you're also helping protect those people. Do you know what's behind these outbreaks in Wisconsin and Minnesota? I mean, is this are these religious groups? Are they a certain population or do we know? We don't know. It hasn't been reported. I think we do know that it has been in tight knit communities in each of those counties in Minnesota. And we do know that adults are playing quite a large role in this U.S. outbreak as well as in Minnesota. So adults that have traveled to other U.S. states like Pennsylvania, Utah, Texas from last year. And then bringing that infection back into a community that is largely unvaccinated, that is a recipe for wildfire and that's what's happening. Yeah, one new case in Scott County was linked to international travel because while we have it eradicated here in the US, there are still other countries in the world where measles runs rampant. So international travel linked to that Scott County case. The median age of those infected is nine and a half years old. So children Why so low, why is the median age of those infected so low? Well, that's for Minnesota. And we typically do see thirds. So young children are about a third, you know, a middle-aged individual is about a third, and then older individuals about a third. And that's following pretty true in Minnesota. What's unique is when you look at some other states like Pennsylvania, they are really seeing adult cases. 41% of the cases there are in adults. So we're really looking at that with the Measles Collaborative and why are adults getting Measles at this point in time and you look back they would have been vaccinated in the in the 90s and in the early 2000s. Well, that was when some of the misinformation came out about MMR vaccine and autism, which has completely been debunked. And so those individuals may have missed their childhood vaccines and now are adults and sadly are even women getting pregnant, having measles. While they're pregnant and then delivering a baby with congenital measles, we have not seen this. And that was an alarm bell for those of us in infectious disease, which is why we started the Measles Collaborative this year to really work together to educate and communicate both clinicians and the public about the dangers of measles. What are some of the symptoms that will be exhibited when you contract measles? Yes. Well, this sneaky virus not only is really easily spread, but it looks like every other infection at first. Runny nose, cough, fever. Okay, you may not be worried about it. But these children especially tend to be much sicker than the common cold. They're sort of dehydrated. They don't want to drink. They have mouth sores. The light bothers their eyes. They're like a rag doll over your shoulder when they come to the emergency room. And they may come to the emergency room two Two or three times and we think, well, it's a viral illness. Now we're testing more for measles. And it's not until that four or five days after that first symptom that they will start to have the rash. That's the telltale. Starts on the face, moves down the face, down the trunk. And then another four days of that rash, you're still infectious. So that's nine days where people can be transmitting to other people. And then the other things it can do is it uses your lymph system as a highway to basically every organ. It'll go to your brain and cause brain infection or encephalitis. It'll go into your gut and cause severe diarrhea, dehydration. It can go into your ears and cause deafness, eyes, cause blindness. It really is a severe disease. And that's why we vaccinate. And that's why those of us who have spent our... Careers talking about measles are really worried about this outbreak. Is there any treatment once you contract it or is the only treatment preventative measures? The main thing to do is MMR vaccine to prevent it because there is no antiviral medicine like we have for other viruses. We don't have. A medicine available and we're seeing our worst fear come true of very sick people in the ICU with encephalitis and we don't really have much to give them. We do give vitamin A once you're diagnosed at very high doses for two days and that's kind of a bridge that helps your immune system see the virus and take care of the virus and brings down some of your bad consequences There's no role for vitamin A in prevention though We don't want people to be doing that at home. It does not help. In fact, it can really harm. Once you are infected with measles, though, it fills in that vitamin A stores that the measles virus wipes out. Okay, so it sounds like MDH has secured additional vaccine doses from the CDC to support local health departments and vaccine outreach workers. That's exactly the right thing to do is so having been through I don't three different outbreaks in Minnesota myself and leading some of these teams that's exactly what we need to be doing is deploying teams to states where there are not only some early cases but big vulnerable communities like we see in the Twin Cities right now if these spread to the Ramsey County, Hennepin County where our vaccine rates are not high enough it will spread and so the The best thing to do... It is to find an MMR vaccine clinic, go to your own clinic, go to a retail pharmacist, and make sure that you're caught up on that MMR vaccine. I'm really happy to hear about that deployment of vaccines. Yeah, so tragic to hear about the death of a baby in Wisconsin yesterday. It's so sad. Yeah. It's so sad. Patsy Stinchfield, the executive director of Measles Collaborative, thanks so much for coming on the show. Thanks for having me. All right.