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Several Measles Outbreaks, Statewide

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    Posted: May 08 2018 at 3:15am

ROCHESTER, NY (WROC-TV) - The New York State Department of Health is warning of a potential measles outbreak at several locations across the state. The warning was issued after an international traveler from Europe was confirmed to have the virus.

Anyone who visited the following locations may have been exposed:

  • Old Country Buffet, 821 Country Route 64, Elmira, NY on April 30th between 1 p.m. and 4 p.m.
  • Ontario Travel Plaza on NYS Thruway (I-90) in Leroy, NY on April 30th between 4 p.m. and 6:30 p.m.
  • Sheraton Niagara Falls, 300 3rd Street, Niagara Falls, NY from 5:30 p.m. on April 30th to 9:30 a.m. on May 2nd
  • Niagara Falls Urgent Care, 3117 Military Road Suite 2, Niagara Falls, NY on May 1st between 3:00 p.m. and 6:00 p.m.
  • Exit 5 on Interstate 390 in Dansville, NY, on May 2nd between 9:30 a.m. and noon

The risk of developing measles is low for people who have been vaccinated or are immune.

Measles is a highly contagious respiratory disease caused by a virus that is spread by direct contact with nasal or throat secretions of infected people. People first develop a fever, then may have a cough, runny nose and watery eyes, followed by appearance of the rash.  People are considered infectious from four days before to four days after the appearance of the rash.

Symptoms usually appear 10-12 days after exposure but may appear as early as 7 days and as late as 21 days after exposure.  Individuals should contact their health care provider if they develop measles symptoms.


Source:   http://www.localsyr.com/news/local-news/health-alert-state-is-warning-of-potential-measles-outbreak-in-western-new-york/1164562960

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Vax Refusals, Reporting Delays Factors in NYC Measles Outbreak

Nearly $400,000 in total direct costs to health department

by Staff Writer, MedPage Today

The majority of patients who contracted measles during a 2013 outbreak and who were eligible for vaccination, either delayed or refused vaccination -- and less than half of them visited a healthcare professional who suspected measles and reported the case to the New York health department, researchers found.

Almost 80% of patients who contracted measles were at least 12-months-old and unvaccinated because of "parental refusal or intentional delay," reported Jennifer B. Rosen, MD, of the New York City Department of Health and Mental Hygiene (DOHMH) in Queens, and colleagues.

Moreover, only 48% of patients visited a healthcare professional who reported the suspected case, while more than a third did not seek medical care, they wrote in JAMA Pediatrics.

In this outbreak, the index case patient was an unvaccinated adolescent who came back to New York with measles after visiting London in March 2013. Researchers performed an epidemiologic assessment and cost analysis of measles cases associated with this outbreak among individuals living in New York City in 2013.

There were 58 case patients with measles from March 13 to June 9, 2013, in two neighborhoods in Brooklyn. The index case patient presented to a healthcare professional with symptoms of measles, and the case was reported to the New York City DOHMH by a commercial laboratory after measles was confirmed via a measles IgM test 8 days after the initial diagnosis of measles was considered, the authors said.

Of the 58 patients, 48 had laboratory confirmation of measles via positive IgM or RT-PCR testing, with the remaining patients classified after onset of rash, based on "epidemiologic linkage" to a confirmed case patients. All of the cases were of the Orthodox Jewish religion.

Median age of case patients was 3 years, and none had documentation that they ever received the measles vaccine. There were 12 patients age <12 months who were too young to have received the measles vaccine through routine immunization.

There was one case of pneumonia and one miscarriage, and one pregnant woman with a rash onset at 37 weeks gestation delivered a baby at 38 weeks gestation. The baby was asymptomatic, but measles virus IgM and IgG were detected on day 9 of life, and was thus the baby was counted as a case patient, the authors said.

About 70% of case patients were members of eight extended families, and about half the cases were presumed to be transmitted from a relative. There were 36% of patients who did not seek medical care for measles, and were identified retrospectively through contact tracing. The authors also noted that many of the case patients were not immediately placed in isolation, which led to exposures in 11 healthcare facilities.

A total of 3,551 exposed contacts were identified, not including the case patients. Two-thirds of contacts had evidence of immunity based on prior receipt of measles vaccination, a positive measles IgG titer or, were born prior to 1957. There were 114 contacts ≥6 months of age receiving the measles-mumps-rubella (MMR) vaccine within 3 days of exposure.

When examining the outbreak's cost, the authors found a total direct cost of $394,448, with about $330,000 of that cost on "compensated personnel time." Of the 10,054 hours responding to and controlling the outbreak, most was done by DOHMH-paid staff during business hours.

In an accompanying editorial, Jason L. Schwartz, PhD, of the Yale School of Public Health in New Haven, Connecticut, said that these estimates were consistent with other reports. He said that they underscore the "resource intensive nature" of public health response to vaccine-preventable disease outbreaks.

"State and local health departments already face substantial budgetary pressures and difficult choices on where to invest limited funds and personnel," Schwartz wrote. "The prospect of having to rapidly redirect resources on the scale required during the 2013 New York City measles outbreak is surely daunting to public health officials, few of whom have in their departments resources comparable with those of the New York City DOHMH."

One study limitation was that time spent on outbreak-related tasks by staff members may have been subject to recall bias.

Rosen and co-authors, as well as Schwartz, disclosed no relevant relationships with industry.

Source:   https://www.medpagetoday.com/infectiousdisease/publichealth/74318


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