Measles is the most contagious disease there is. It can make people very sick, even hospitalize or kill them. Vaccination is the answer, yet up to one half the children in the Copper Country have not been vaccinated against measles.

Michigan has the lowest measles immunization rate in the country, and Houghton County is among the lowest in the state. Houghton County’s rate of unvaccinated children is four and half times the national average.

What would happen if a measles outbreak hits the Copper Country? “Hopefully not pure panic,” says Dr. Robert Van Howe, medical director of the Western Upper Peninsula Health Department. Though, he adds, there is plenty to panic about.

Measles spreads like wildfire, with every infected child or adult infecting up to a dozen others, according to the Health Department’s medical director. Compare that to COVID, where one infected person usually spreads it to two to four others. Nine out of 10 people exposed to measles will contract it, Dr. Van Howe says.

If an outbreak hits the Keweenaw, it will impact businesses, schools, churches, families, any place people gather. Dr. Van Howe says it could overwhelm health care providers, including hospitals, doctors and the Health Department.

Are Health Providers Prepared?

Are health care providers in our area ready to handle a measles epidemic? “My answer is NO,” says Rajanee Sripaipan, a pediatrician with the Upper Peninsula Family Health Center.

According to the CDC, since measles is so contagious, just walking into the waiting room exposes unimmunized patients¸ she explains.  “One in five measles patients can be very sick and need to be admitted to a strict airborne isolation room.  Our hospitals will not be able to accommodate more than one such patient.”

The measles virus stays infectious in the air for two hours, Dr. Van Howe points out. That means if an infected person coughs or sneezes in a room, people can catch measles up to two hours after that person has left.

According to the Mayo Clinic, measles typically begins with a mild to moderate fever, a dry, hacking cough, a runny nose, inflamed eyes and a sore throat. Then a rash appears, usually first on the face. Over the next few days, the rash spreads down the arms, chest and back, then over the thighs, lower legs and feet. At the same time, fever rises sharply, often as high as 104 to 105.8 degrees Fahrenheit.

Unfortunately for early detection, there are no symptoms of measles for the first 10 days to two weeks after infection. During this time, the infected person can spread the disease without even knowing they have it.

The complications of measles can be very serious, even deadly. In addition to severe pneumonia and acute encephalitis, which causes brain swelling, measles can cause a fatal complication called subacute sclerosing panencephalitis seven to 10 years after infection.

Dr. Van Howe has treated patients hospitalized with measles. “These kids are really sick,” he says. Worldwide, in 2022, measles killed approximately 136,000 people, according to the World Health Organization.

Why so Few

vaccinations

Why are so few children vaccinated against measles? “There’s a whole generation of people who have never seen measles,” Dr. Van Howe explains. The measles vaccine was developed and licensed for use in the United States in 1963, and in 1971, a combined measles, mumps and rubella (German measles) vaccine came on the market. Most children were vaccinated automatically before they started school, and measles became rare.

Today’s parents don’t realize how serious measles can be or how easily it spreads, says Dr. Van Howe. Most of today’s health care providers haven’t seen the havoc that measles can cause either. So vaccination levels and attention to prevention in medical settings have dropped.

Preparing Ourselves

What needs to be done to prepare the Copper Country for a measles outbreak?

Parents, teachers and health care workers need to become more informed about measles and to recognize its early signs. “And vaccinate their kids now, before measles hits our community,” Dr. Van Howe says emphatically. “The measles vaccine is completely safe.”

Dr. Sripaipan urges the community to review the March 21 online article in the Mining Gazette documenting the rise of measles.

“Community leaders, clergy, schools, preschools, neighbors, friends and family should help spread information about the importance of vaccination,” she says. “The vaccine is safe and effective in preventing infection and complications.”

As for health care workers, “We need to better educate our nurses, receptionists and other employees to identify the red flags for measles, so they can promptly isolate the patient, regardless of the vaccination status of the health care worker,” Dr. Sripaipan says. Another option is to examine the patient in the parking lot rather than an exam room, performing the necessary tests to confirm the diagnosis, she suggests. “This will mitigate the spread of infection.”

Even after a person has been exposed to measles, a vaccination within 72 hours of exposure can stop the virus in its tracks, both Dr. Van Howe and Dr. Sripaipan point out.

If people are exposed and not vaccinated promptly, they need to quarantine for 21 days, the Health Department medical director says. Quarantining for three weeks would impact businesses, whose workers couldn’t come to work. It could close schools, keeping more working parents at home with their kids. “It could have a huge impact on the local economy,” says Dr. Van Howe.

Health care facilities and schools need to require both children and adults–including their staff–to produce proof of vaccination,” Dr. Van Howe says. And schools and health care providers should stop accepting non-medical waivers, adds Dr. Sripaipan.

Schools, businesses and health care providers need to work with hospitals, emergency services and the Health Department to prepare in advance for a measles epidemic, says Dr. Van Howe.

The Health Department is already acting. Its medical director says his staff are talking to schools and health care facilities about what to do if a measles outbreak occurs. They’re preparing pamphlets about measles and vaccination, to educate the public. They’re working with emergency services on preparedness, fine-tuning their contact system and setting up a supply chain to make sure they get enough vaccine.

Health care workers need to notify the Health Department quickly if they see any measles cases, so the Health Department can notify schools and people likely to have been exposed, Dr. Van Howe says.

As for the public, “Answer your phone,” Dr. Van Howe urges parents and others in the community. “It may be the Health Department contacting you about measles exposure.”