Prevention the key to keeping measles out of Indian Country

TULSA, Okla. — There is a run on soap in the Thompson household.

With one of Arizona’s seven recently reported cases of measles based just 30 minutes away from their home on the San Carlos Apache reservation, Dr. Renee Thompson and her husband are not taking any chances with potentially exposing their two young sons.

Along with regularly washing their hands thoroughly, the Thompsons are taking active steps to prevent their sons from catching the virus. After researching all of the potential pros and cons, their older son, Wyatt, is vaccinated, along with both of his parents.

Because Renee is current on all of her shots, the couple’s younger son, Carter, has passive protection from her antibodies until around his first birthday in September. He is also receiving additional exposure to his mother’s antibodies through breast milk.

“We are very worried, particularly due to our toddler’s tendency to have breathing difficulties with any viral infection or illness he catches,” said Renee, a citizen of the Absentee Shawnee Tribe.

“We have also been concerned for our baby’s health since he is unable to be vaccinated and measles can be fatal to infants. Not to mention working in a health care field and around children causes me to worry about carrying the virus home with me.”

Despite the disease being declared eradicated in the United States in 2000, 170 cases of measles have been reported in the United States through February 2015, compared to 644 cases across 27 states in all of 2014.

Eighty percent of the reported cases in 2015 have been linked to a single infected person’s trip to a theme park in California.

A 2013 study by the Centers for Disease Control indicates that with their smaller numbers, Native American children receive the MMR vaccine at a higher rate nationwide than the general population. However, the exposure rates tell a slightly different story.

Of the 17 states with at least one reported case, four of the five states with the country’s largest American Indian and Alaska Native populations are on that list: California, Arizona, New York and Texas.

Nine out of 10 unvaccinated people who come in contact to someone with measles will develop the illness.

The virus is spread by contact with droplets via the air when an infected person breathes, coughs, or sneezes. Measles can remain contagious on surfaces and even in the air for up to two hours after an infected person leaves an area.

Infected individuals are contagious up to four days before the trademark raised red rash starts to appear and can share the virus for up to four days after the rash’s initial appearance.

If left untreated, measles can cause diarrhea, ear infections, pneumonia, encephalitis or subacute sclerosing panencephalitis, a rare but fatal disease of the central nervous system.

One in four people who contract the measles will be hospitalized either because of the virus itself or due to its side effects.

“Measles can be a very serious disease and people do need to be protected,” said Dr. Anne Schuchat, the assistant surgeon general, United States Public Health Service and director of CDC’s National Center for Immunization and Respiratory Diseases. “Measles spreads quickly among unvaccinated people and can spread quickly from state to state or around the world. We must ensure that vaccination rates remain high among children as well as ensure that adults receive MMR vaccine if they’re not already protected against this virus.”

Dr. Adrian Jacobs, a member of the Lumbee Tribe of North Carolina, is a pediatrician with a small clinic in Lumberton, North Carolina. Her practice has not had a spike in calls from parents concerned about the outbreak, something she partially chalks up to the fact that so many of her clients are already vaccinated against the disease.

Statewide, an estimated 96 percent of North Carolina children received the MMR vaccine through 2013, more than 3 percentage points higher than the national vaccination rate.

“We have had a few parents discuss the current outbreak during visits, and ask questions regarding symptoms, but the majority of our patients have vaccinated their children with MMR and have not expressed any concerns,” Jacobs said.

Meanwhile, back in Arizona, the Thompsons continue to monitor the measles situation in their state and keeping a weather eye on their two young sons.

“We are staying educated on what symptoms to watch for and suggested practices to keep them safe,” she said. “We are fortunate that my husband is able to be a stay-at-home dad with the boys while they’re on a wait list for preschool. That has helped us tremendously in reducing the potential exposure to the measles.”

 
© Native Health News Alliance

This story is produced by the Native Health News Alliance (NHNA), a partnership of the Native American Journalists Association (NAJA).