Clark County Public Health reported no new confirmed measles cases or exposure sites Tuesday. There were 11 suspected cases reported.
While there has been a recent drop-off in exposure sites, the cost of the outbreak continues to mount for Clark County.
Jeff Harbison, the administration services director for Public Health, said the outbreak has cost about $325,000 so far. There is $450,000 budgeted for the first 30 days of response, a period that ends on Feb. 14.
“We’ll probably come in fairly close, probably slightly under” budget, Harbison said.
The ongoing outbreak investigation has identified 49 confirmed measles cases since Jan. 1. There is also a confirmed case in King County and one in Multnomah County, Ore.
Confirmed cases also include 34 children ages 1 to 10; 13 youths ages 11 to 18; and one adult between 19 and 29.
Of the 49 cases confirmed, 42 had not been immunized against the highly contagious virus. Immunization status could not be verified for six cases, and one case involved a child who had received only a single does of the MMR vaccine.
Visit this link for a list of exposure sites: www.columbian.com/news/2019/jan/29/measles-exposure-sites.
In that same time frame, Bend, Ore., had two exposure sites identified, but so far, no confirmed cases in that area have been reported.
A costly response
The outbreak is costing about $17,500 per day, with most of that cost going to labor. Public Health is having to pay mileage for Medical Reserve Corps volunteers helping out in the response — that mileage is from their home to Clark County. Some volunteers are coming from as far as the King County area.
Public Health pays for their lodging in Clark County, and a per diem for breakfast and dinner. Volunteers and incident command personnel have lunch provided by Public Health as well.
“They really don’t have the opportunity to leave campus and then come back,” Harbison said.
Since the outbreak response began, Public Health has attempted to contact 850 people who may have been exposed to measles during the outbreak. Public Health has completed contact with 645 people, while 197 were contacted with no reply, Clark County Public Health Public Information Officer Marissa Armstrong said.
Each person with a confirmed case of measles has to be interviewed along with family. Public Health has to identify places they might have gone while contagious.
If a clinic is an exposure site, then Public Health has to contact other patients present during the exposure window, and also see if they brought friends or family with them who might not be on the patient roster, said Clark County Public Health Director Dr. Alan Melnick. For schools, the process can be even more intensive, especially since some buses are used for multiple schools.
“These may sound like large amounts of money, and they are, but it’s also a very large amount of work and staff time,” Melnick said.
Grant funding might be in jeopardy for some positions that have shifted over to assist in outbreak response, and the county has also shifted positions that help in collecting fees for the county, such as food inspections. Those are other important costs that come with an outbreak, Melnick explained.
Armstrong said Public Health is “re-evaluating staffing pretty much everyday to make sure we don’t have more people that we need here, that we’re not over-staffing, that people are busy and working.” Harbison added that Public Health tries to be efficient with spending as much as possible. Public Health has rented computers from county surplus for $200 a month, instead of buying new ones for thousands of dollars.
“My staff are very dedicated county employees,” Harbison said. “We track our costs very diligently. We try to make the most cost-effective purchases. We try to stick within a certain budget for measles. We’re not buying steak and lobster. We’re trying to be diligent harbingers for taxpayer funding.”
What to do if you might be infected
The Centers for Disease Control and Prevention reports that 90 percent of unvaccinated people exposed to the measles virus come down with the disease. The virus lives in the nose and throat mucus of an infected person, and can survive for up to two hours in an airspace where the infected person coughed or sneezed.
Health officials are urging anyone who has been exposed at an identified location and believes they have symptoms of measles to call their health care provider prior to visiting the medical office to make a plan that avoids exposing others in the waiting room.
If you are unsure of your family’s immunization status, you can view, download and print your family’s immunization information online at wa.MyIR.net or request a copy of your immunization record from the Washington State Department of Health.
Anyone with questions about measles infection or the measles vaccine should call their primary care provider or a county health department:
Clark County Public Health, 360-397-8021.
Multnomah County, Ore., Public Health, 503-988-3406.
Washington County, Ore., Public Health, 503-846-3594.
Clackamas County, Ore., Public Health, 503-655-8411.
Clark County Public Health has been regularly updating its list of locations where people may have been exposed to measles. There are dozens of locations in total, including hospitals, Portland International Airport and multiple schools.
Public Health has established a call center for questions related to the investigation. Anyone who has questions about public exposures should call 360-397-8021. The call center is open daily.
For a complete list of exposure sites, visit the Public Health measles investigation webpage at www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Measles/MeaslesOutbreak.
Measles symptoms begin with a high fever, cough, runny nose and red eyes, followed by a rash that usually begins at the head and spreads to the rest of the body. A person can spread the virus before they show symptoms.
People are contagious with measles for up to four days before and up to four days after the rash appears. After someone is exposed to measles, illness develops in about one to three weeks.
