Source: http://www.wisn.com/health/15817542/detail.html
Young Girl Hospitalized With Measles
POSTED: 4:32 pm CDT April 7, 2008
MILWAUKEE -- Health departments in Milwaukee County are on alert after a young girl is diagnosed with measles.
The 23-month-old Franklin girl is hospitalized and is expected to make a full recovery, but experts' concern on Monday is that the girl may have spread the disease while attending day care facilities in Greenfield and Greendale prior to being diagnosed.
Measles, once a leading cause of death in the United States, has become increasingly rare since a vaccine was developed in 1963, though it isn't given to children younger than 12 months old. About one case in 1,000 leads to death, but other complications include encephalitis and pneumonia.
While the health departments aren't providing specifics about the girl or the day care centers she attended, they said they have notified the parents of all of the other children.
"The day care did have people, children, under the age of one, so we're working to identify those children and issue any quarantine orders that might be needed," said Darren Rousch of the Greenfield Health Department.
Measles begins with cold-like symptoms but then develops into a rash about eight to 12 days after exposure. The patient is contagious, however, a few days before that.
"Probably during the next week or so would probably be a prime time when, if this child did pass the measles along to anyone else, that we might start to see those cases show up," Milwaukee Medical Director Dr. Geoff Swain said.
Source: http://www.wisn.com/news/15836061/detail.html
Second Milwaukee-Area Case Of Measles Confirmed
Health Department Confirms 'Outbreak'
POSTED: 1:19 pm CDT April 9, 2008
UPDATED: 5:06 pm CDT April 9, 2008
MILWAUKEE -- The Milwaukee Health Department on Wednesday confirmed a measles outbreak with the second confirmed case of the disease.
Also: Doctor Says Measles Cases Likely Related; More Expected
Milwaukee Health Commissioner Bevan Baker said the new case is a male Milwaukee resident who developed measles-like symptoms, went to the doctor, and had the diagnosis confirmed. The man's symptoms predate those of a 23-month-old girl who recently became ill, Baker said.
Authorities said they are investigating whether the two cases are related.
"This is no matter to take lightly. Vaccine-preventable disease is something that we all should be concerned about and measles is one of those concerns that we need to get out in front of, so I would tell the public, make sure you take the precautions to not only protect you and your family, but to protect our community at large," Baker said during a Wednesday afternoon press conference.
Adults are urged to ensure vaccinations for themselves and their children are up-to-date, as the immunization is highly effective against the disease.
The last large outbreak of measles in Wisconsin was in the winter of 1989-1990, when more than 1,600 cases were reported statewide, resulting in 200 hospitalizations and five deaths. Three of those deaths were in the Milwaukee area.
Measles, once a leading cause of death in the United States, has become increasingly rare since a vaccine was developed in 1963, though it isn't given to children younger than 12 months old. About one case in 1,000 leads to death, but other complications include encephalitis and pneumonia.
The Milwaukee Health Department has created a measles hot line to solicit questions about the disease or to take any reports of symptoms. The telephone number is 414-286-3616.
Source: http://www.todaystmj4.com/news/local/17754429.html
Milwaukee Health Department: Confirmed Case Of Rubella
Ty Milburn
Katie DeLong
MILWAUKEE – Milwaukee Health Department officials announced a confirmed case of rubella in Waukesha County during a press conference Tuesday afternoon.
The symptoms of rubella include fever, swollen lymph nodes and a rash.
The problem with the measles outbreak appears to be getting worse. We learned Tuesday there are three more probable cases of measles that have been reported and a case of German measles as well.
Officials say they are treating the probable cases like the real deal. The new probable cases are spread throughout southeast Wisconsin, including a case in Milwaukee, Racine and Walworth County.
The city's health commissioner says the outbreak is serious.
“This is a growing trend and an alarm to the public health community to see this increase in vaccine preventable diseases,” Milwaukee Health Commissioner Bevan Baker said.
Officials also report in Waukesha County, someone has contracted rubella or German measles. It's a less severe form of the measles, and it's so rare no one has had it since the 90s.
Wisconsin Commissioner of Insurance Press Releases::
Measles vaccine a mandated Consumer Alert--Wisconsin residents are cautioned by UW Milwaukee to Host Governors Health Care Listening Session
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Greendale News for April 2008 - Topix::
Greendale, WI News Archives for April 2008 in Milwaukee County are on alert after a young girl is diagnosed with measles.
http://www.topix.com/city/greendale-wi/2008/04HOME |
“The main way to prevent rubella is through vaccination and the good news is that the vaccine that we use for the measles is a three in one vaccine. It contains protection for measles, rubella and the mumps,” Waukesha Communicable Disease Supervisor Rosie Kapp said.
Officials say the only way to prevent getting the measles is by getting vaccinated.
Source: http://www.jsonline.com/story/index.aspx?id=749000
Containing measles
Officials scramble to keep outbreak under control
By MEG KISSINGER and SUSANNE RUST
mkissinger@journalsentinel.com
Posted: May 11, 2008
Mary Rotar was getting ready to head home for the weekend, when the call came late that Friday afternoon.
The 23-month-old girl with the rash and fever does have measles, the state health lab technician said.
"My heart just sank," said Rotar, infection control officer at Children's Hospital of Wisconsin in Wauwatosa.
A measles outbreak, rare as it is these days, can be devastating. It's highly contagious; someone sneezing across the room can pass it along, and the germs linger for as long as two hours.
Nearly everyone over 50 remembers having measles - the fever, the red blotches and the sting caused by even a slight beam of sunlight. In its heyday in 1958, measles affected more than 800,000 across the country.
But a vaccine developed in 1963 worked wonders. By 2000, the disease had been declared eradicated in the United States.
There are occasional outbreaks, though. The last big one here, in 1989-'90, infected more than 1,100 people in the city and killed six children across the state - four babies, a 10-year-old and an 11-year-old.
Rotar knew they would have to move fast if they were going to contain this one.
But how much exposure had there been?
The little girl had been admitted to Children's Hospital the previous Monday. She was moved into isolation on Thursday when the doctors suspected measles. But in those three days in between, she potentially had been in contact with as many as 30 of the sickest, most vulnerable children - transplant and cancer patients, kids with almost no ability to fight off infection.
The disease can be deadly for those with compromised immune systems. The virus settles in their chests and their lungs fill with fluid. They can suffocate in hours.
"I was so scared that someone was going to die," Rotar said.
She would have to move quickly to find out who had been in contact with the little girl. Rotar called Sandy Coffaro, Milwaukee's communicable disease coordinator who oversees this type of investigation.
"This is not a drill," Rotar told her.
And then, more bad news: The little girl had been at two day care centers while she was infectious.
Coffaro, who spent more than a year working to contain the outbreak of 1989-'90, took a deep breath and made special note of the time: 4:18 p.m.
Since that moment on April 4, Milwaukee and suburban public health workers have been scrambling to keep this outbreak from spreading.
23-Month-Old Child Has Measles | Todays TMJ4 - Milwaukee, Wisconsin ::
MILWAUKEE - Theres a measles scare in Milwaukee County. eNews & eNews Alerts. TMJ4 Text Alerts. Read more My Personal 4 Cast. Mobile. Read more
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Health Officials: Dont Take Measles Lightly | Todays TMJ4 - Milwaukee ::
The state is alerting physicians, health departments, infection-control Measles are rare, with fewer than 10 cases each year in Wisconsin since 1989 and
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"It's a little bit like putting a broken glass back together," Rotar said. "You just hope you can find all the pieces."
•
The City of Milwaukee Health Department allowed the Journal Sentinel unprecedented access into the workings of its active epidemiological investigation as it straddles the delicate line between sustaining heightened public awareness and avoiding mass hysteria.
Paul Biedrzycki, director of disease control and environmental health for the city, serves as incident commander. He runs tight meetings, charting new cases on a board, chiding those who fail to put their cell phones on vibrate, keeping a rein on the discussion.
Biedrzycki goes around the table, scouring the most minute details: exact wording on the hotline and city Web pages, staffing for the weekend immunization clinics, what kind of laptop computers will be on site, if there are enough refrigerators to keep the vaccines sufficiently cold, whether the fliers announcing clinic times have been translated into Spanish and Hmong.
In addition to old-fashioned "shoe-leather epidemiology," modern health care investigators now have tremendous tools - sophisticated genetic tests, BlackBerry devices, cell phones and computer programs.
These things were the stuff of science fiction when epidemiologist Kathy Blair headed up a similar effort during the 1989-'90 outbreak. In those days, Blair and her crew of 103 public health nurses camped out at each of the area's busiest emergency rooms and pediatrician's offices, trolling for bloodshot eyes, in hopes of flagging a measles case.
In those days, as cases piled up at a rate of 80 a week, public health care workers went door to door, drawing blood in homes and vaccinating children in their own bedrooms. They stationed a nurse at every school.
Today's public health care work force is roughly half that size, and they are able to track the disease with electronic reports from hospitals and doctor's offices. But for all the electronic wizardry at their disposal, Biedrzycki's crew faces hurdles that Blair's group did not. The biggest of these is, ironically, a product of their own success.
Because measles is rare now, parents and even some doctors don't think to look for it. Few are aware of how devastating it can be to a baby or someone with a weak immune system. Measles - out of sight for years - is also out of the minds of health care planners. Many emergency rooms and doctors' offices are not set up to limit the exposure of such a highly contagious disease.
Investigators for the Centers for Disease Control and Prevention have learned that more than a third of the 70 confirmed cases nationwide so far this spring were contracted within a health care facility - a doctor's office, walk-in clinic or hospital.
Growing pockets of parents are opting out of having their children vaccinated. They are skeptical - or scared - of what the vaccines can do to children, though there is no scientific evidence that the vaccines cause harm. Parenting chat rooms are filled with discussions about the safety of today's vaccines and whether there is any link to the rise in autism. The number of parents filing personal conviction waivers in Wisconsin over the past 10 years has tripled.
•
Rotar was still at Children's Hospital well after midnight that first day, trying to track down the families of any children who might have come into contact with the 23-month-old.
What Rotar did not know then was that this little girl was not the first case. Weeks earlier, a 37-year-old Milwaukee man had come down with the disease, but the blood tests were sent to a lab in Utah and the results were not yet known. The man had gone to two health clinics before he ultimately was diagnosed at Aurora St. Luke's South Shore Hospital.
Now health care workers would have to try and find everyone who had been in either of those clinics or in that emergency room and let them know of their exposure.
Rotar had a specific plan to contain the spread of measles at Children's.
Anyone suspected of having the disease would be moved to one of the hospital's six negative-pressure rooms, places where the air flows through the room at a much more rapid rate and is filtered before being released back into the building.
It was decided that those children who were most vulnerable - transplant patients and those on chemotherapy - would be given shots of immunoglobulin to boost their immunity.
Anyone showing up in the emergency room with symptoms would have to wait in the parking lot until proper precautions could be made.
"We couldn't risk spreading it any further," Rotar said. "I was determined not to let that happen in my waiting room."
It turned out that the little girl who was the first diagnosed had been immunized for other childhood illnesses but had not gotten the shot for measles, mumps and rubella.
Because the girl, who lived in Franklin, had gone to two day care centers - one in Greenfield and the other in Greendale - while she was contagious, city and suburban workers would have to contact dozens of families. When two others at the Greenfield day care - a 5-month-old and a 12-month-old - started showing signs of measles, health care workers ordered them quarantined. After several days with no new cases being reported, suburban health administrators were declaring qualified victory.
"We think we've nipped this in the bud," said Darren Rausch, Greenfield health officer.
•
No sooner had health care workers been getting a handle on the measles outbreak when word came from Waukesha.
A man in his mid-50s, back from a vacation in Mexico, had rubella. A week later, a Waukesha County woman in her 30s also was confirmed to have rubella. She worked at the Foley & Lardner law firm in downtown Milwaukee. Health officials estimated that she had come in contact with at least 700 people at work and hundreds of people on the Freeway Flyer bus that she rode.
Though covered by the same vaccine, measles and rubella are two different diseases. That both would break out at the same time is "just freaky," Coffaro said.
Rubella, more commonly known as German measles, is not as contagious. Some people who get rubella don't even know it.
But it is devastating to fetuses. Nearly half of all pregnant women who are exposed to rubella in the first trimester give birth to babies with rubella syndrome, a birth defect that causes blindness, deafness, heart deformities and mental retardation.
"I didn't even know I was pregnant when I came down with it," said Michelle Moore, who had rubella in 1964. "They figured later that I was about four weeks along."
The rash covered her from head to toe. It showed up on a Saturday and was gone by the end of the next day.
Her son, Michael, was born six weeks prematurely with rubella syndrome, weighing 4 pounds, 8 ounces.
"He hasn't said a word to me in 43 years," said Moore, of New Berlin. Nor can he walk or dress himself.
Moore says she cringes when she hears of parents today who don't immunize their children against these preventable childhood illnesses.
"To say, 'I don't want my child to get sick with autism or whatever,' well, you might be killing someone else's unborn child," Moore said.
She says she loves her son very much. But taking care of him has been a huge challenge. She has to cut her son's food, bathe him and pull him out of bed each morning.
"Our last vacation was in 1979," she said. "It scares me to death that another family can go through this."
Biedrzycki estimates the City of Milwaukee has spent more than $120,000 in overtime so far fighting the measles outbreak. Federal health officials say they expect it to go on for several more weeks.
"I don't think we can relax for quite a while yet," said Geoffrey Swain, the city's chief medical officer.
Source: http://wkbt.com/Global/story.asp?S=8258493
Reported by Jenna Sachs
Measles Outbreak Hits Small School
The seventh case of the measles in Wisconsin has affected a small high school in Vernon County.
The girl afflicted with measles is one of 48 students at Viroqua's Youth Initiative High School. School administrators spent much of their time on Thursday making sure all other students have their measles immunizations up to date.
"We're taking this real seriously," said Liz Fox, the school administrator. "We'll take all the quarantine recommendations and guidelines very seriously."
Health department officials have instructed the school to put any student who refuses the vaccination under quarantine.
"We are offering immunizations there, and they need to watch and see if there are any symptoms in the students," said Beth Johnson, director of the Vernon County Health Department. "If they're [not vaccinated], they need to be quarantined after school to make sure they're not out in the community."
Doctors say a disease like the measles can spread rapidly between students and between communities.
"It is one of the most highly infectious diseases," said Dr. Raj Naik, a pediatrician at Gundersen Lutheran. "There are certainly possibilities of spread beyond the area."
Fox has been in contact with the student who has contracted the measles, and says she is doing well. As for the other student, the school is looking out for anyone with symptoms. The symptoms include fever, sore throat and a rash.
State and local health officials are working to identify the source of the disease. Right now, they don't believe it's related to the six cases diagnosed previously in Southeastern Wisconsin.
Source: http://www.dailycardinal.com/article/2749
last updated: April 17, 2008
Wisconsin takes a step back in time
By: Jennifer Evans /The Daily Cardinal - April 17, 2008
As old diseases resurface in Wisconsin, health officials fear public may no longer trust vaccines
Last week was bad for infectious diseases in Wisconsin. Measles and mumps, diseases seemingly reduced to only a memory in the United States by the introduction of vaccines, suddenly began making headlines once again.
By Thursday, the state health department confirmed four cases of measles in the Milwaukee area, leading hundreds to seek the measles vaccine at free clinics throughout the city over the weekend.
Scientists also published a study in the New England Journal of Medicine (NEJM) Thursday, showing the resurgence in the number of mumps cases reported in the United States in recent years, particularly among 18- to 24-year-old college students living in the Midwest.
Although the measles outbreak in Milwaukee and the resurgence of mumps across the country are separate issues, James Conway, a UW-Madison associate professor of pediatrics, said both cases highlight a growing concern in the medical community that a rising number of children in the United States are not receiving their recommended vaccines.
An unhealthy movement “It’s a growing trend for parents not to immunize [their children] because they haven’t seen the devastating effects of these diseases the way [older generations] did,” said Craig Roberts, a University Health Services epidemiologist.
According to Conway, measles are a much more dangerous and contagious disease than mumps. Measles, commonly characterized by a body rash, can cause brain damage and death in severe cases, while mumps often cause swelling of the glands running along the jawline, according to the Centers for Disease Control and Prevention. Mumps are rarely deadly, but complications can include sterility and deafness.
Stephanie Marquis, spokesperson for the Wisconsin Department of Health and Family Services, said the state and local health departments are doing all they can to contain the measles outbreak in Milwaukee, but expects the number of measles cases in the state to grow.
“Measles can transfer easily and rapidly through the air,” Marquis said. “People don’t know they have [measles] until the rash appears eight to 10 days after [infection].”
Vaccine laws and waivers In 1982, Wisconsin began requiring children to receive one dose of the MMR vaccine, an immunization cocktail offering protection against measles, mumps and rubella. Several mumps outbreaks in the late-1980s led the state to begin requiring that children receive a two-dose MMR regimen, starting in 1990.
Today, doctors recommend children to receive the MMR vaccine between the ages of 12 and 15 months, and four and six years. According to Conway, the two-shot regimen is 99 percent effective against measles and 95 percent effective against mumps.
In Wisconsin, parents can refuse to have children immunized by filing a medical, religious or personal conviction waiver. A 2004 study in the Wisconsin Medical Journal showed that while the filing of medical and religious waivers in the state remained constant between 1990 through 2003, the number of parents filing personal conviction waivers steadily increased.
Conway said he suspects the growing number of parents choosing not to vaccinate is a combination of people “losing sight of the disease” and the vocal anti-vaccine movement, which argues vaccines are to blame for the rise in the numbers of autism cases in the United States.
More harm than good? A 1998 Lancet paper by U.K. scientists fueled the anti-vaccine movement after it suggested the existence of a connection between MMR and autism. However, efforts to repeat the U.K. study and numerous studies since have led the CDC and the majority of the scientific community to acknowledge that there is no scientific link between MMR and autism.
“The connection between autism and vaccines has been studied to death and there is no cause-and-effect relationship between [them],” Roberts said.
Yet, the announcement by the CDC last Friday that it would work with vaccine critics to explore vaccine safety issues shows the government is open to additional studies to examine whether or not the relationship between autism and vaccines exists.
Conway said the dip in the percentage of the population receiving vaccines in the United Kingdom has had no effect on the rates of autism in the country. Instead, the country’s low vaccine rate of only 70 percent of the population has led to numerous outbreaks of measles and mumps.
“People forget about diseases and begin paying attention to rumors about vaccines,” Conway said. “It is a disservice to the community for a person to say ‘I’m not going to vaccinate my kids. As long as everyone else vaccinates their kids, my kid will be fine.’ If 10 to 20 percent of parents think the same way, then boom, outbreak.”
According to Conway, when vaccination rates fall below 80 percent of the population, “an outbreak is waiting to happen,” and the decrease in population vaccine rates appears to be rippling across the Atlantic Ocean.
Closer to home While the recent measles outbreak in the Milwaukee area occurred in people who did not receive the MMR vaccine, the resurgence of mumps occurred in those who had previously received the required two-dose regimen.
The NEJM authors speculate that those who received the two-dose regimen of the MMR vaccine are losing immunity to mumps over time.
Marquis said the loss of immunity to mumps in combination with people living in close proximity on college campuses may be to blame for the higher mumps resurgence rates among college students compared to rest of the public.
“We always suspected the need for a better mumps vaccine,” Conway said, pointing to the mumps outbreaks of the late-1980s that led to the country to shift to a two-dose MMR regimen. The NEJM report may now force doctors to re-evaluate the ability of the two-dose regimen to protect against mumps throughout one’s lifetime.
“So many people protect kids by buckling their seatbelts in a car and giving them helmets when they bike. You don’t know what day they’ll be in an accident, but you do it anyway,” Conway said. “A vaccine is the same. You can’t choose the day a disease is going to be introduced into the community. You can’t just only vaccinate if there’s an outbreak.”
Source: http://www.todaystmj4.com/news/local/17677164.html
Free Measles Vaccine Turnout Disappoints MPS Officials
Tom Murray
MILWAUKEE - April Flanagan's daughter has all of her shots for kindergarten next year, but many of her classmates may not be ready.
"I'm a big advocate of immunizations," said Flanagan, who is also a nurse. "I feel a lot safer. At least my children are protected."
About one third of the students who walk into MPS schools everyday are not properly immunized. Officials are troubled why more families did not take advantage of free vaccinations offered by the City of Milwaukee's Health Department (MHD).
"I thought they would be overwhelmed by people," expressed Roseann St. Aubin, MPS Spokesperson. "At least that was my hope."
About 200 children got measles shots the free clinics Saturday, according to MHD figures. That's a small number when MPS estimates at least 26,000 students are not vaccinated. Two clinics, one on the north side and one on the south side, were open for four hours each. MPS tried to get the word out by sending home fliers in English and Spanish.
Officials now fear the outbreak will reach schools. The district sent principals photos of the measles rash so they can spot the highly-contagious illness.
"All of us who are writing these e-mails and trying to guide principals are hoping it's not the principal who has to identify measles because, by that time, you've got it in your building," St. Aubin told TODAY'S TMJ4 reporter Tom Murray.
Most MPS students had the no school Monday for what's called a Banking Day. With no students in buildings, the district asked principals to work on getting in touch with parents of children who have not been vaccinated. MHD is considering more free vaccination clinics to curb the spread of measles.
There are four confirmed cases of measles. Three children with ties to a Greenfield daycare were infected. Measles is also confirmed in a Waukesha County adult.
Source: http://www.jsonline.com/watch/?watch=1&date=4/11/2008&id=38257
FRIDAY, April 11, 2008, 11:42 a.m.
By Meg Kissinger
City sets up measles vaccine clinics
The Milwaukee Health Department has set up two clinics Saturday to vaccinate people against measles. The clinics will be open from 10 a.m. to 2 p.m. at the South Side Health Center, 1639 S. 23rd St., and the Keenan Health Center, 3200 N. 36th St.
Public health officials are bracing for a massive outbreak, as four cases have been confirmed this week - three young children and one adult. The last measles outbreak in 1989-1990 left 1,011 people in the city infected. Three children died.
The Health Department has set up a hotline to provide information. The telephone number is (414) 286-3616, and is staffed Monday through Friday 8 a.m. to 4:30 p.m.
Updates will be posted on the department's Web site:
http://www.milwaukee.gov/health
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