By Diantha Parker and Timothy Williams
The New York Times
January 30th, 2015
The measles outbreak tied to Disneyland continued to spread anxiety Friday as two new cases emerged overnight in Marin County in California — along with at least one in Nebraska — while Arizona officials warned that at least 1,000 people may have been exposed to the virus through seven others in that state.
Since Jan. 1, the federal Centers for Disease Control and Prevention haveconfirmed 84 measles cases in 14 states. California’s health department, which is updating a measles count more frequently, has found more than 90 cases in the United States and Mexico so far, with 52 linked to the Disneyland outbreak.
Concern about the highly contagious disease intensified Friday in several states, including Minnesota, where health officials are notifying hundreds of people who may have come into contact with a University of Minnesotastudent with measles.
There was also anxiety in Arizona, where thousands of people are arriving in Phoenix for the Super Bowl on Sunday. The disease centers are now advising anyone with symptoms not to attend the game.
“The very large outbreaks we’ve seen around the world often started with a small number of cases,” said Dr. Anne Schuchat, director of the agency’s National Center for Immunization and Respiratory Diseases.
Officials in three counties in the Phoenix area — Maricopa, Gila and Pinal — have already asked residents who have not been vaccinated and who might have been exposed to stay home from school, work or day care for 21 days. Schools in some other states are considering more formal bans on unvaccinated children.
“This is a critical point in this outbreak,” the Arizona state health director, Will Humble, wrote on his blog. Any missed cases, he wrote, could cause “a long and protracted outbreak.”
Each case so far has spawned an exhaustive public health response.
News sites in Pennsylvania and other states are alerting readers when measles-infected individuals have visited local establishments, an effort to warn residents of exposure. And in places like New Mexico, where the number of unvaccinated children increased 17 percent from 2012 to 2014, health officials are warning that the disease could soon hit.
In Minneapolis, the Minnesota Department of Health said Friday that it is working with the University of Minnesota to manage the case of measles diagnosed in a 20-year-old male university student. It has notified other students who may have been exposed, along with health officials at the hospital where he sought treatment.
“We are going to be watching this situation very closely,” the Minnesota commissioner of health, Dr. Edward Ehlinger, said.
Dr. Ehlinger emphasized that the potential risk to the general public is very low, but said people should take precautions to protect themselves and their children. In particular, he called on parents to make sure their children have been properly immunized.
A spokesman for the state health department, Doug Schultz, said the student had probably contracted the measles on a trip to Indonesia. The student told health authorities that he had received two doses of the measles, mumps andrubella vaccine, Mr. Schultz said, but that it was unclear when he had received his last shot.
The vaccine, Mr. Schultz said, is about 95 percent effective, so it is possible for people who are current with their vaccinations to contract the virus. In Minnesota, about 1.6 percent of people decline to be vaccinated, Mr. Schultz said.
In Nebraska, Leah Bucco-White, a spokeswoman for the Department of Health and Human Services, said Friday that officials had confirmed two cases of measles in children in the eastern part of the state.
The first case is related to the Disneyland outbreak, Ms. Bucco-White said, but the origin of the second case remained unclear. “We’re still investigating the source of exposure.”
Health officials in Nebraska are recommending a quarantine for individuals who may have been exposed, and are sending out information to health care providers on what kind of symptoms to watch for.
Public health officials from across the nation have made appeals in recent days to have their children immunized, and there are signs that the trend away from vaccination may be reversing in at least some locations.
In Maricopa County, Arizona, three clinics have experienced a surge in visitors requesting measles vaccinations for their children, according to health officials, who reported a 50 percent rise in vaccination requests over last year.
The clinics have added nurses, and lines have begun to form. One visitor was a parent from Mesa who had two children, ages 12 and 14, who had not received measles vaccinations.
“If you’re trying to make lemonade out of the situation,” said Jeanene Fowler, a spokeswoman for the county health department, “that’s the best we can ask for.”
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