In 2000, the Centers for Disease Control and Prevention announced the elimination of measles in the U.S. But earlier this year, the Pacific Northwest sent a reminder to the rest of the country that the ’90s were still alive when we had an outbreak of the disease.

Locally, Lane County Public Health says it’s ready in case measles makes it to the area, but it’s a challenge to deal with the disease.

Washington state has seen 54 confirmed cases of measles, according to the state’s Department of Health. In Oregon, four cases have been reported, all in Multnomah County.

The outbreak of measles has frustrated some lawmakers, especially Gov. Kate Brown, who, while on the campaign trail in 2018, said the state probably gives too much leeway about vaccinations.

“I cannot emphasize enough to parents the importance of getting your children vaccinated. I think we need to strengthen our legislation around vaccination exemptions to protect our kids from entirely preventable diseases,” Brown told Eugene Weekly in a recent email.

Jocelyn Warren, division manager at Lane County Public Health, says she isn’t optimistic that measles will be contained in northern Oregon and southwest Washington state.

Although 93 percent of school-age children in Lane County are vaccinated, private schools in Eugene have low percentages of students who have measles vaccinations. Two of the private schools with the lowest vaccination rates according to Oregon Health Authority’s data are Village School (43 percent) and Eugene Waldorf School (47 percent).

Put another way, those two schools have lower vaccination rates than most sub-Saharan African countries, according to data from the World Health Organization. Parents in Oregon can exempt their children from vaccines for non-medical reasons.

To achieve community immunity — also known as herd immunity — 94 percent of the population must be vaccinated. Community immunity acts as a buffer for those who are unable to receive a vaccination, such as infants, those too young for vaccines or those with weakened immune systems — like children fighting cancer, Warren says.

A 2015 study published in Science concluded that measles in children erases the immune system’s memory of pre-measles diseases. By contrast, a measles vaccination strengthens the immune system, which provides better health for those who are vaccinated.

Most measles cases occur in children. The disease starts with a runny nose, watery eyes and maybe a cough. But, unlike the flu, measles develops into another symptom: little white spots in the back of one’s throat called Koplik spots, according to the CDC.

Complications from measles get worse than flu-like symptoms. The CDC reports that one in every 20 children gets pneumonia, the most common cause of death from measles in young children. One out of 1,000 can develop a swelling of the brain, which can lead to an intellectual disability. One or two out of 1,000 will die from the disease.

Measles virus particles can stick around inside a room for two hours after the infected person sneezes or coughs, Warren says.

The pathway for a measles case being reported starts with a phone call. If someone were to call with suspected measles, the public health office considers the symptoms as well as the patient’s travel. In this case, the public health office would investigate whether the patient traveled to Portland or somewhere in southwest Washington.

Once a measles case is confirmed, each case is then treated with a higher priority.

The health agency must make announcements to warn the public about the possible contact, Warren says.

Although the county likely won’t see a large measles outbreak, since there is a high vaccination rate in public schools, just a few cases could overwhelm the county’s communicable disease team, which consists of four full-time nurses, Warren says.

“It takes a lot of work to respond and control these diseases,” she says. “You have to follow up with all the people who have been exposed, you have to follow up with all the providers who have questions about the best way to treat. It’s enormously time intensive.”

If measles does spread to Eugene, Warren says the county is ready to deal with it. However, she says the return of the disease is frustrating. “What’s killing people is chronic disease,” she says, referencing conditions like heart disease and diabetes.

“These are the real health threats and that’s where we should be really focusing our energy. How do we create a community in which people can make healthy choices in which healthy behaviors are the easy things to do?”

Lane County Public Health will have a two-day, walk-in immunization clinic on Tuesday, Feb. 19, and Wednesday, Feb. 20. 

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