State health officials have confirmed an ongoing measles outbreak in Kentucky – the largest in the commonwealth in 35 years. As of Friday, 15 cases have been connected to this outbreak, with the majority identified in western Kentucky.
Officials have confirmed 10 measles cases in Christian County. Two cases have been reported in neighboring Trigg County, and another in Todd County.
This outbreak is part of a nationwide trend of rising measles cases that health experts have connected to lowering vaccination rates across the country.
WKMS’s Hannah Saad spoke to Dr. Chris Toler, chief medical officer for Deaconess Health System’s Kentucky facilities – which includes hospitals in Hopkinsville, Henderson, Morganfield and Madisonville – about the highly contagious disease and how people can protect themselves during this outbreak.
Hannah Saad: What makes measles different from other contagious diseases that typically travel around – especially during the fall and winter months?
Chris Toler: Measles is actually a virus that is similar to other viruses, but it is one of the most contagious viruses out there. So that's one of the problems in general. With vaccinations, there is a high level of immunity that happens within communities. And so, when the vaccination rates within communities fall, that then allows multiple people to become infected, and the virus to be able to maintain itself and to spread.
HS: One of the other things about measles, too, it seems like there's also a long time [about one to two weeks] between when a person could be exposed and when they might develop symptoms. Is that right?
CT: That's true. But from the time that people develop symptoms, some of the first symptoms are very common to other viruses: a high fever, a cough, runny nose, red watery eyes — those things are what people are sort of used to with common cold viruses. So they don't suspect a measles infection. Measles [was] also very rare until [recently] with the changes in vaccination. But what then happens is after about two to four days, you'll start to notice a rash that generally starts on the face and then continues down into the trunk or to the chest area. Also around the same time, some tiny white spots appear in the mouth, and those are sort of the hallmark of what people think of when they think of the measles. But this prodrome, or the things that happen before [rash and white spots] actually happens, are so common that that's also what allows [measles] to spread because people don't suspect that's what it is.
HS: Are there people that might be more at risk of developing measles compared to other groups?
CT: The main group at risk is the unvaccinated, so that's the key point… There's a lot of controversy right now, especially politically, around vaccinations. And so that's sometimes confusing to the population and understanding what recommendations to listen to and to follow. There's been a lot of very recent recommendations of vaccines in general, not necessarily specific to the measles.
According to the Kentucky Immunization Registry, 6-year-olds in Christian County had one of the state’s lowest county vaccination rates for measles last year. Under 60% of those kids were considered fully vaccinated against the highly contagious virus.
But those who are unvaccinated are highly susceptible [to measles]. People who are immunocompromised are also [at risk, including] cancer patients, patients being treated with certain medications, [people with] HIV, babies who have not been vaccinated – who are not [unvaccinated] by choice, it's just not time for them to be vaccinated. The first vaccinations don't happen until around that 12 to 15 month mark, and then the second dose of the vaccine happens around the 4 to 6 year [mark], so about that kindergarten timeframe.
Those are your general high risk populations that are most susceptible, and that's also why we think about vaccinations in general. And you can think back to COVID, when we talked about being vaccinated against viruses. At that point, the more people that get vaccinated in a community, you develop what's called herd immunity or community immunity. And what that means is that there's nowhere for the virus to really go because such a large percentage of people are vaccinated. And so, one of the recommendations around most of the viruses and infectious diseases [is] that if we can get the community vaccinated, we're protecting those people who aren't able to medically take a vaccination, like people who are immunocompromised or infants and [people with] other certain diseases that doesn't allow for the vaccination.
HS: Would you have any advice for parents who might have questions about the measles, mumps, and rubella (MMR) vaccine that helps protect against these diseases? Where would you recommend folks take their questions if they're questioning whether they or their children should receive this vaccine?
CT: I think one of the best sites, if we're talking about children [receiving vaccines], is the American Academy of Pediatrics. They've actually released their own set of recommendations. They've broken with the federal government and with the CDC, as have most of the professional medical organizations, so that would be one of the better places to start. Also, your local health department is very tied to the state health department, and so they're a great resource. They're also very knowledgeable about the activity of the virus within their communities that they're serving or their counties.
HS: Is there anything else that you think community members or Kentuckians should know at large about measles, how to move forward with this outbreak and knowing best practices on containing the spread of this disease?
CT: I think the key points are always: This is a completely preventable disease with vaccination. So we highly encourage vaccination. If you're unsure if you've been vaccinated — because it does happen when you're a child — you can contact your primary care provider, your pediatrician, or the local health department. And if you've had two of the shots, two in the series, you are considered vaccinated and have immunity. So I think that's a great place to start.
Secondly, if you have symptoms that you suspect could be the measles, or you've been exposed to the measles, it's always important to notify the health department. Call your physician or your practice before you arrive so that they're aware that that's happening, and so you're not waiting with other patients and given the opportunity to infect others in a waiting room…Most locations have some policy in place that helps, once someone's identified [to potentially have measles], a way to work with them and treat them without exposing other patients.
