Medical and public health officials in Santa Barbara County are straightforward about addressing the debate surrounding vaccinations.
“Simply put, people who choose not to vaccinate are putting others at risk for serious illness,” said Dr. David Fisk, an infectious disease specialist with Santa Barbara Cottage Hospital. “They are relying on the initiative that others take to get vaccinated for their own protection. … I think we need to take a fresh look at that practice.”
He made those statements during a press conference on Jan. 28, following the Santa Barbara County Public Health Department’s announcement of a possible measles case in the county. The next day, on Jan. 29, the health department received news that the possible case tested negative for measles. Between Jan. 1 and 30, the California Public Health Department confirmed 91 cases of measles in the state in at least 10 counties; the majority of them are in Southern California, and 59 of them are linked to an outbreak that started at Disneyland. Ventura County has seven confirmed cases.
Dr. Takashi Wada, director of the county’s health department, told the Sun that he couldn’t release information on what the potential case in Santa Barbara County turned out to be, but did say that the initial symptoms for measles are similar to many other viruses. A fever, coughing, and a runny nose—the way measles manifests itself in the beginning stages—are common symptoms for many viruses. So is a sort of conjunctivitis akin to pink eye that comes along in the middle stages.
“That’s what makes it so hard to diagnose,” Wada said. “There’s a lot of investigating that goes into a case like this.”
By the time the characteristic rash shows up on the face and starts spreading down the body, measles has been around and infectious for a couple of days. Because the initial stages of measles are similar to other viruses, the health department has received several phone calls about potential cases, but they have a measured approach to determine whether someone is likely enough to have the disease to warrant testing. With that testing also comes the tasks of reaching out to others who have been in contact with the person, administering vaccines or boosters to potentially exposed people, quarantining them, and announcing the potential case to the county.
The first piece of the puzzle includes assessing that person’s risk of being exposed to another person who has a confirmed case of measles.
Dr. Charity Thoman, the county’s health officer, spoke at the Jan. 28 press conference, saying that there are so many diseases circulating around that the county is expecting more potential cases to get reported.
“The vast majority of those are unlikely [to be measles],” she said, adding that people who think they may have the virus shouldn’t rush to the doctor’s office—and risk exposing everybody along the way because it’s a contagious, airborne virus—but call ahead, so doctors and medical professionals can be prepared.
Wada told the Sun that there are typically a small number of measles cases each year in the United States, but those cases are generally tied to other countries (most recently the Philippines and Vietnam). The outbreak in Disneyland is suspected to have originated out of the country as well. But in 2014, there were more cases of measles—644 cases in 27 states, according to the Centers for Disease Control and Prevention—in the United States than there have been in 60 years.
“This is the greatest number of cases since measles elimination was documented in the U.S. in 2000,” the CDC stated about 2014. So far in 2015, the number of cases nationwide is at 102 (as of Feb. 2), and they’re all linked to the outbreak at Disneyland.
Wada thinks that the increasing number of children/people who aren’t getting vaccinated is worrisome and has contributed to the recent outbreaks of measles and whooping cough—the state had the highest number of whooping cough cases in 2014 than it had in a couple decades.
“These are serious illnesses, and also a reminder about the importance of vaccinations,” Wada said.
Both the California Department of Public Health and the CDC say the majority of the measles cases are found in unvaccinated people. The state only has vaccination information on 45 of the cases in the current outbreak, according to Carlos Villatoro, a public health department spokesperson; 36 of those cases are unvaccinated, six had two or more doses of appropriate vaccine, and three had a single dose.
The county health department is urging people to make sure they’re up-to-date on their vaccinations, get vaccinated, wash their hands, and use “other good practices to stay healthy.”
“We haven’t had a case in Santa Barbara County that anyone can remember,” Wada said. “Because measles is a virus that is highly contagious, it wouldn’t be entirely surprising if we had a local case.”
Contact Managing Editor Camillia Lanham at clanham@santamariasun.com.
This article appears in Feb 5-12, 2015.
