Los Angeles Times

Measles burdens hard-hit county

Butte County copes with ‘a new disaster every few months.’

- By Soumya Karlamangl­a

Camp fire area copes with “a new disaster every few months.”

Northern California health workers are scrambling to control a growing measles outbreak centered on a region that is still reeling from the most destructiv­e wildfire in state history.

In November, the Camp fire devastated the town of Paradise, killed 85 people and left behind billions of dollars in damage. Butte County, about 90 miles north of Sacramento, continues to grapple with the consequenc­es of the blaze.

So the arrival of measles seems to residents like just the latest in a string of bad luck. As of Friday, at least 15 California­ns had been diagnosed with measles as part of the outbreak that began last month in Butte County, according to health officials.

“It feels like we keep getting hit with a new disaster every few months,” said Cassie Miracle, who runs a health coalition in Chico, the biggest city in Butte County.

Measles outbreaks have been popping up across the country this year, with hundreds of cases in New York and Washington state. Experts chalk it up to fewer people being vaccinated in the U.S. and across the world; Americans are now more likely to encounter measles abroad, and when they return, the infection is more likely to spread here.

The Butte County outbreak began when a man caught measles in March during a trip to the Philippine­s, where thousands of people have come down with the disease this year. The outbreak has expanded outside Butte to Placer, Tehama and Shasta counties.

In attempting to halt a measles outbreak, health workers map every place patients went for four days before and after the characteri­stic rash appeared, when patients are thought to be the most infectious.

Then the investigat­ors try to contact anyone who may have come near the patient and verify if they are immunized. If those people already have measles symptoms, they will quarantine them. It’s an arduous process in normal circumstan­ces.

But the 13,900 homes destroyed in the Camp fire last year included some belonging to Butte County health staff. Some employees moved away, further stretching a department that was struggling to meet the needs of its beleaguere­d community, said department spokeswoma­n Lisa Almaguer.

In the fire’s immediate aftermath, county health workers sheltered thousands of displaced animals and treated people living in

shelters, where there was also a norovirus outbreak. Now workers are still busy verifying that properties are cleared of hazardous materials and helping deal with a major water contaminat­ion problem, she said.

The measles outbreak has confirmed what feels like a chaotic “new normal,” Almaguer said. The department is considerin­g calling in reinforcem­ents to help with measles control as the outbreak grows, she said.

“We are having those conversati­ons,” she said. “Our staff is working much longer hours during the day than normal, and we have staff on call over the weekends, and we continue to investigat­e suspect cases.”

Where is measles clustered in state?

U.S. health officials declared measles eradicated in 2000, but so far this year there have been 555 cases nationwide, they say. One of the most contagious diseases in the world, measles is the first to return when a region’s immunity falls, experts say.

In California, 23 people statewide have been diagnosed with measles this year, according to state data released Thursday. Though the Butte County outbreak is the largest cluster, there have been a smattering of cases around the state.

On Wednesday, health officials warned that a person infected with measles spent time on the Google campus in Silicon Valley. Recently, Long Beach officials alerted travelers that a passenger visited the airport twice while infectious.

In Placer County, health staff started scrambling last month when three people fell sick after visiting the home of the original Butte County patient, said Michael Romero, program manager for the public health department.

County health staff obtained a list of 285 people who were at a gym when the measles patients were also there so they could call them, Romero said.

But it was a tall order for the county’s seven-person investigat­ion team, so they enlisted 25 people from all over the health department in their race against the clock, he said. Nurses were calling people in between their normal duties.

“This is one of those allhands-on-deck sort of responses,” Romero said. “In my time with the county in the last 16 years, I can’t remember the last measles investigat­ion like this.”

Why the outbreak hasn’t mushroomed

California may be spared from the larger outbreaks affecting other states because of a state law that tightened vaccinatio­n standards three years ago, experts say.

California’s new law bars parents from excusing their children from vaccines because of their personal beliefs. Now, kids can only escape vaccinatio­ns if a doctor says they have a medical reason to do so.

Since the law went into effect, California’s kindergart­en vaccinatio­n rate has increased from 92.9% to 95.1%, according to state data. Doctors say a community needs at least 95% immunity to prevent measles from spreading.

Counties afflicted with measles this year tend to have low vaccinatio­n rates.

Butte County’s kindergart­en vaccinatio­n rate is close to the state average, but Placer’s is 92.3% and Shasta’s is 90.1%.

“When folks [aren’t] taking vaccinatio­n recommenda­tions seriously, this is what can happen,” said Tim Mapes, community education specialist with the Shasta County health department.

Before two people in Shasta County came down with measles this year, there hadn’t been a measles case there since 2014, he said. One of the county’s measles cases is linked to the Butte outbreak, but officials have not yet determined the origin of the other, he said.

Mapes said Shasta health workers retrieved data from ride-hailing companies Lyft and Uber to determine who rode in the same cars as the measles patients so they could contact them and warn them about the exposure.

They also got a list of from a Walgreens store of customers who might have been there at the same time as the people who were sick.

“It’s a big deal when you see a disease that is as contagious as this pop up after five years in your community,” he said.

“You don’t want to start seeing that.”

 ?? Frederic J. Brown AFP/Getty Images ?? HEALTH OFFICIAL Dr. Jeffrey Gunzenhaus­er briefs the media on a measles outbreak in Los Angeles in 2015.
Frederic J. Brown AFP/Getty Images HEALTH OFFICIAL Dr. Jeffrey Gunzenhaus­er briefs the media on a measles outbreak in Los Angeles in 2015.

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