Is it a cold? Or is it measles?
Clark County’s measles outbreak is presenting challenges to local schools, Clark County Public Health and the county’s medical care system. There’s an added challenge of this outbreak coming during cold and flu season, which is starting to crank up — the last county influenza report clocked flu positivity at a season-high 12.2 percent.
“Some of the early measles symptoms can mimic other infections, so you have to sort out who could potentially have measles and who doesn’t,” said Dr. Eric Chang, Legacy Health medical director for infectious diseases.
Both Legacy Health Salmon Creek and PeaceHealth Southwest Medical Center have protocol in place to deal with the outbreak and treat potential measles cases while not infecting other patients.
As part of that protocol right now, PeaceHealth is not allowing visitors who are unvaccinated, children younger than 12, or people with immunodeficiency disorders. Those rules stand until the outbreak is over. Legacy has the same rules, except for immediate family members of the patients, and PeaceHealth can make exceptions to their rules under extreme circumstances.
Legacy is also excluding visitors who present symptoms such as a cough, sore throat, fever and runny and stuffy nose, and if PeaceHealth staff notices any visitors exhibiting those symptoms, they will address that person and investigate that potential sickness.
Christie McDaniel, a registered nurse and the PeaceHealth Medical Group director of ambulatory services, said clinics are very focused on “identifying patients that have been suspected for exposure or they have symptoms.”
The clinics can coordinate a handoff with the hospital, where a patient can be met outside by proper medical staff and assessed for measles. That assessment is fairly quick, and if a person is identified to potentially have measles, they are given a mask to wear and escorted through a private entrance into a negative pressure airflow room, where further treatment and testing can be done.
Hospitals generally recirculate air through their building, said Dr. Jason Hanley, PeaceHealth Southwest Medical Center Emergency Department Medical Director. But the negative pressure airflow room pulls air up through the ceiling, and spits it outside, where the virus can’t contaminate anyone else. These rooms are used year-round to deal with patients who might have airborne or droplet transmission infectious diseases, but they’ve seen an uptick in use at PeaceHealth and Legacy during the outbreak.
“We have had parents bring children in who did not have measles to be checked,” said Kelly Love, a Legacy spokesperson. “Awareness is heightened.”
Hospital staffers are posted near entrances, ready to ask incoming patients if their visit is measles-related. Love said that process has been quick and easy because for measles it’s generally going to “be young patients coming in with a parent or an adult coming in with them,” she said. “It takes about three seconds to ascertain that the patient is concerned about measles.”
Public Health has urged people to call ahead to clinics and hospitals for measles-related visits. McDaniel said that’s been happening at clinics, and Hanley said it’s mostly been happening for the emergency department, too, and some of the patients they receive are hand-offs from the clinics. Love said Legacy’s emergency department has generally not received calls directly from patients in this scenario.
“The operators have gotten different phone calls from people concerned with what the symptoms are of measles and they have information,” Love said. “But the operators have not received calls from people saying, ‘I’m about to bring a child in,’ and that’s likely more the nature of what an (emergency department) represents in the community, which is emergency care and that they just bring the patient in.”
Both hospitals frequently coordinate with Public Health on suspected cases. They also both have measles signage posted. Hanley said staff is being extra thorough about asking patients to visit for assessments, instead of just relying on phone calls to investigate potential measles cases.
“The majority of patients don’t have measles, but it’s so difficult for parents to make that determination,” Hanley said. “Usually pediatric nurses and family practitioner nurses, over the phone, are excellent about getting a feeling of sick versus not sick, but when the consequences of spreading measles to the community is so great we don’t want to miss any cases at all. Everyone is airing on the side of caution.”
