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Anatomy of a measles case: How one clinic struggled to keep a confirmed measles case contained

Undark details what happened after a mother walked into a Lowell clinic last fall with her daughter, who had measles.

Bonus fun fact: The first photo in the article is of the clinic offices in the Dr. Morris Greeley Parker Building, which is named for a friend of Alexander Graham Bell, who came up with the idea of using numbers instead of names for telephone customers during a measles outbreak in Lowell - while wondering what would happen if all four of the city's operators at the time contracted measles at once.

H/t Rob Eno for the Parker history.

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Comments

Instead, they came to the center and disclosed to a medical assistant upon arrival that the child had contracted measles abroad.

Did the parent know that the kid had measles before boarding an international flight, arriving and Boston, and visiting the clinic in Lowell?

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Kid just wasn't old enough for the second shot/booster.

That means 2 things:
1. the onset may have been very mild
2. they may not have realized that it was measles.

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From the story:

The mother, however, disclosed that her daughter had developed a cough and runny nose on November 3 and a fever and a rash the following day. But the fever and most of the illness’ telltale spots were gone by November 7, when the family flew back to Logan Airport in Boston, so the mother assumed the child was no longer contagious. Still, a nurse in Africa had diagnosed the illness. “I put a lot of stock in that statement,” Dykstra says. “A nurse in Africa knows what measles looks like.”

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That is some good reporting.

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We're backsliding into the dark ages. In a time where we could be advancing into the future and making the world a way better place to live, we're more content with believing in bullshit woo about vaccines. I'm just waiting for polio to return with a vengeance.

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This was a "young kid" situation. The kid was up to date on vaccines for his/her age ... meaning first shot only. The first shot was just not sufficient in this situation.

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.

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You assume that she got it from somebody who rejected vaccination, rather than someone who lacked access to vaccination.

Those are two VERY different things, hon.

Note that most of the people who went to that clinic that day were known to be vaccinated, and a large additional number had titers that needed to be reviewed. That's because old farts like me have vaccination records from school campaigns, military, or county clinics in the days before these things were tracked systematically or required.

In other words, many of those who were asked to report for vaccination were likely to have been vaccinated or may even have had measles - there was simply no time to run the tests to confirm that.

IN THIS PARTICULAR CASE herd immunity existed in Massachusetts.

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I have paperwork showing I got one dose of measles vaccine when I was less than a year old. The (New York City) health department doesn't have a record of that, because it was too long ago--I know because I asked them for my records, and they obligingly sent what little they have, which is a lot more recent.

From memory, I got a second measles vaccine, or maybe MMR, when I was in college, but college health services don't hang onto those records this many years past graduation.

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But I don't recall any major measles outbreaks before the anti-vax psychopaths started making trouble.

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This wasn't a major outbreak - this was an exposure incident.

The major outbreaks are the result of anti-vaxxers, no doubt. This particular child, however, was vaccinated.

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No, this was still an "irresponsible parent" situation. Worse than an anti-vax parent, the parent in this story knowingly exposed hundreds of people to a contagious disease instead of acting responsibly.

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The child contracted measles while traveling in an area where it is endemic. The parent didn't know that the child was still contagious after the symptoms faded.

Same issue with the norovirus outbreaks on cruise ships. People don't realize they are still contagious for an additional two weeks after they feel better. So they get sick before their cruise, recover in time to still catch their flight and board the ship. And then cruise from hell for everyone else.

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Just because the parent said they didn't think the child was contagious, do you believe them.

1) The child got diagnosed on November 3. Child flew home on November 7. The same day they arrived, the parents sought medical attention. That's not a sign that symptoms faded.

2) The child was diagnosed by doctors knowledgeable about measles. Did they really not discuss recovery?

3)The child still had rash/spots on day 3 when flying home. Who on earth thinks that measles is no longer contagious after 3 days?

4) The parent didn't google "how long is measles contagious?" Yeah, right.

5) The parent didn't think to mention "measles" when calling the Lowell clinic? They already knew what it was.

The parents almost definitely knew the child was still contagious, but their travel plans were for the 7th so they stuck with the 7th. The parents definitely didn't act responsibly.

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This was an incredibly interesting and educational story! I am so impressed by the health center’s response and their candid debriefing. Lots to be learned from and be thankful for here.

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