Vaccination waivers by county

TRAVERSE CITY — Measles was declared completely eradicated in the United States nearly two decades ago.

Now, 19 years after public health officials said the only new cases in the U.S. stemmed from infected travelers, the highly contagious disease is making a dangerous comeback with more than 700 confirmed cases across 22 states.

Officials said Monday the national tally — just four months into the year — already eclipsed the total for any full year since 1994, when 963 cases were reported. The Michigan Department of Health and Human Services announced Wednesday that new cases of measles were found in Oakland County and Detroit, bringing the state's 2019 total to 42.

"If a person walks into a room with a hundred unvaccinated people and spends a little time there, probably 90 of the 100 will get measles," Michael Collins, medical director at the Grand Traverse County Health Department, said.

Although the measles outbreak is contained to southeastern Michigan, local health officials are now working with school officials to prepare for the disease's arrival. The Grand Traverse County Health Department partnered with Traverse City Area Public Schools and sent out a letter to students, families and staff Thursday to inform them about the disease and what will happen if a confirmed case is found within the district.

"We're choosing to be proactive, getting the information in the hands of families," TCAPS Executive Director of Human Resources Cindy Berck said. "In the end, they will make the decisions relative to their next steps. We're encouraging staff to take it seriously and consider their next steps."

One confirmed case of the measles in a TCAPS daycare or school will force the health department to bar all individuals who cannot prove they have either received the MMR vaccination or have previously had the disease from entering school grounds. The exclusion will last for 21 days after the last case has been identified, which is the timeline to develop symptoms after exposure.

Grand Traverse County has one of the highest percentage of students who have been given a vaccination waiver at 7.7 percent, as of Dec. 31, 2018, according to the MDHHS. The state average is 3.6 percent. That ranks Grand Traverse 80th out of 84, with more than 1,000 unvaccinated students. Neighboring counties aren't much better. Leelanau ranks 78th at 6.6 percent, Kalkaska 70th at 5.2 percent and Antrim 45th at 3.9 percent. Benzie is the only county with a lower percentage (3.5) than the state average and ranks 35th.

"It certainly is possible that we will get cases here," Collins said. "Because of the relatively high waiver rate, it's much more likely that we would have it spread widely and have a community-wide epidemic."

A waiver can be granted through a local health department for a valid medical condition or "if the parent or guardian holds religious or philosophical beliefs which preclude receipt of a vaccination." State law requires any person seeking a nonmedical waiver receive education regarding the benefits of vaccination and the risks of disease for not vaccinating.

Seventy-five percent of the 700-plus cases this year are children or teenagers. No deaths have been reported, but 66 have been hospitalized.

Measles usually causes fever, a runny nose, cough and a rash all over the body. A very small fraction of those infected can suffer complications such as pneumonia and a dangerous swelling of the brain. CDC officials estimate that for every 1,000 children who get measles, one or two will die from it.

Joshua Meyerson, medical director of the Health Department of Northwest Michigan, said there are no current cases of measles spreading in northern Michigan that health officials are aware of.

However, the outbreaks in other parts of the state and country provide a good reminder for people to either get vaccinated or check on their vaccination status.

"It's why we want to maintain the highest immunization rates we can at all times," Meyerson said. "All it takes is one person who is susceptible, and if he enters a population that doesn't have high immunization rates, you can have a spread of the disease."

Meyerson said vaccinated adults born after 1957 should be protected. Those who either do not have records showing they have been vaccinated or don't remember should contact their doctor or local health department for a consultation. Babies usually get their first dose of the MMR vaccine between 12-15 months old, but doctors are authorized to administer the vaccine to infants as young as 6 months old in the case of an outbreak. Those younger than 6 months or with immune suppression issues should avoid public places where there is an outbreak.

"I encourage all parents to fully protect their children against all vaccine-preventable diseases by immunizing them," Meyerson said. "It behooves all of us to provide a safe place for our children to go to school."

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