The country is experiencing the worst year for measles in a quarter century, according to CDC, with 704 reported cases. And New Jersey is right in the middle of an outbreak.
The state has 14 confirmed cases, with a suspected case reported last week in Middlesex County. Though New Jersey hasn’t been hit nearly as hard as New York City and Rockland County, New York, where hundreds have been infected, experts remain concerned if we fail to limit the disease’s spread. Just how bad could it get here?
While it’s unlikely New Jersey would ever see hundreds or thousands of cases at once, the state could see localized epidemics with “pockets of people with low vaccination rates getting many infections,” Dr. David Cennimo, an infectious disease expert at Rutgers New Jersey Medical School, said via text message.
Failing to get a handle on measles could strain the state’s medical system and divert health care personnel.
Cennimo said the state is already seeing a “disruption in medicine because of concern for measles.” Treating a measles patient is often tedious and cumbersome, he said.
“Measles is airborne, so people need to stay in special negative-pressure rooms. … These rooms aren’t plentiful,” Cennimo said in an email. “You cannot have a patient walking into a waiting room with measles without a mask on because they can infect everyone.”
Measles is so contagious that 90% of susceptible people exposed to an infected person will become infected, according to the CDC. If outbreaks continue, experts worry about measles patients walking among the public or in hospitals, potentially spreading the disease to vulnerable populations, like babies who’ve yet to receive the vaccine. Those with weakened immune systems, like cancer patients undergoing treatment, would also be at-risk.
Medical personnel may have to ramp up protocols for dealing with patients reporting vague symptoms like a rash or fever. They may have to meet potentially infected patients in the parking lot with masks, diverting staff from other serious health matters.
“All of this is cumbersome and, if it delays care, potentially dangerous,” Cennimo said. “It is difficult for your average primary care doctor or pediatrician to do all of this in a busy office. The measles rash is not very specific and can be confused with other viral rashes.”
He added, “This can really slow down the flow in an (emergency department).”
Prolonged measles outbreaks could also come at a significant cost, according to New Jersey Assemblyman Herb Conaway, D-Burlington, who is one of the sponsors of a bill seeking to eliminate a loophole that allows thousands of parents to cite religious beliefs as a reason to opt out of vaccinating their children.
“We know that the failure to vaccinate leads to enormous preventable health care costs … lost work, not going to school, the cost of hospitalization and outpatient care. In an aggregate, those costs are enormous,” Conaway said.
In fact, a study looking at Washington state, which has also been hit particularly hard by measles in the past several weeks — primarily due to people who were not vaccinated — looked at just how costly dealing with measles outbreaks can be.
The study, published last month in the medical journal JAMA, said that “responding to a single case of measles can be as high as $142,000.” This includes tracking cases, laboratory testing, quarantining patients, compensating health care providers, public outreach and other measures needed to prevent further spreading of the disease.
The study estimates that in 2011, the total cost of outbreaks in the U.S. ranged from $2.7 million to $5.3 million. In that year, 220 cases of measles were reported, according to the CDC.
Though there isn’t a single reason for the recent resurgence of measles, health experts maintain that the anti-vaccination movement has proven to be a problem, and one that needs to be addressed as the spreading of misinformation and propaganda continues to impact vaccination rates. A 93% to 95% immunization rate is needed within a community to prevent measles from spreading among the population, according to the World Health Organization.
“If we continue to have pockets of unimmunized children, we will continue to see outbreaks,” said Dr. Glenn Fennelly, chair of pediatrics, Rutgers New Jersey Medical School.
New York City’s measles outbreak has been primarily affecting ultra-Orthodox Jewish communities in Brooklyn, where vaccination rates tend to be lower and anti-vaccination sentiments common. The outbreak grew so bad that New York City officials earlier this month declared it a public health emergency and ordered mandatory vaccinations.
New Jersey’s outbreak, while less severe, has also been largely concentrated in ultra-Orthodox Jewish communities in Lakewood, Ocean County (as has the outbreak in Rockland County, New York).
“We have more and more people who are choosing not to vaccinate themselves or their children, and that is putting not only themselves at risk but everyone else at risk, particularly the young and those who are medically vulnerable,” Conaway told NJ Advance Media.
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