U.S. measles cases top record, putting measles elimination status at risk

Study profiles hospitalizations, complications, cost
In a new research development, a profile of measles illnesses in children in two Minnesota outbreaks found high hospitalization rates and costs and that poor feeding and secondary bacterial infections were among the complications from the disease. Researchers based at Children’s Minnesota hospitals published their findings today in a case series in The Pediatric Infectious Disease Journal.

To characterize clinical findings and hospitalizations for measles, the analysis included children hospitalized for measles from 1 January 2011, to 1 September 2017, during which two measles outbreaks occurred in Minnesota: one in 2011 and the other in 2017. The study included 33 patients, 7 from the 2011 outbreak and 21 from the 2017 outbreak. All but two of the patients were black or African American, the majority of whom were from the Somali community. All but three were unvaccinated.

Poor feeding was the primary hospital admission reason, while other complications included ear infection, pneumonia, tracheitis, and keratitis. Additional tests such as chest radiographs and blood cultures were common, and 73 percent of the patients received antibiotics. The median length of hospital stay was 3.7 days, and the team estimated that the total cost to the hospital for just the 2017 outbreak was $1.3 million.

The team concluded that clinicians should be aware of measles complications and that public health efforts should continue to focus on immunization, given the high burden on patients and health facilities.

Anti-vaccine campaign on social media continues
Amid the growing measles crisis, the conspiracy-fueled anti-vaccination campaign of lies and misinformation continues unabated on social media. The Wall Street Journal reports that ten weeks after Facebook pledged to fight vaccine misinformation, such content remains widely available across its platforms as the social-media giant grapples with how aggressively to limit the spread of hoaxes and deceptions.

Facebook is still running paid ads for an anti-vaccination group that claims that unethical doctors conspire with pharmaceutical companies to conceal evidence that vaccinations harms children. The Journal notes that both Facebook and its Instagram app recommends additional anti-vaccination misinformation to users who view similar material. The top three vaccination related accounts which Instagram recommends to Instagram users are all engaged in spreading the lie that vaccination is toxic.  

Peter Hotez, the dean of Baylor University’s school of tropical medicine, told the Journal that he had not observed any changes since Facebook said it would intervene. The company’s activities to date on anti-vaccination content are “the minimum possible in order to give the illusion of corporate responsibility,” he said.

DHS considering imposing a travel ban
To fight the measles outbreak, airlines, health officials, and federal authorities are now considering banning people exposed to the measles from flying.

Eight people across the country have “voluntarily” canceled their travel plans in lieu of being placed on a federal do-not-board list maintained by the Centers for Disease Control and Prevention (CDC), which would prevent them from stepping foot on a plane, the Washington Post reported. The eight individuals were either confirmed to be infected or had a high probability of having the disease (that is, they were not vaccinated and hung out with someone who had the measles).

The do-not-board list would be a collaborative effort between state and local health officials, the airlines, the CDC, and the Department of Homeland Security. According to CNN, health officials would attempt to dissuade a contagious passenger from traveling on a plane, and if their verifiable attempts fail, they can contact the CDC for assistance. If their efforts fail, the CDC will work with the airline to cancel the flight and waive fees, while the Department of Homeland Security would place the person on a public health do-not-board list, which tells the airline not to issue a boarding pass.

Fast Company reports that per the CDC, sick travelers can also be placed on a Lookout list so they can be detected if they attempt to enter the U.S. Typically, the threat of ending up on a government list is enough to prevent people from trying to fly.

Fast Company writes:

Travel bans for infectious passengers are rarely used by the government, but in the face of the growing measles outbreak and the persistence of anti-vaccine misinformation fueling the spread of the disease, the U.S. is considering resurrecting the do not board list. That list was first implemented in 2007 to block a man infected with drug-resistant tuberculosis from traveling to Europe, according to the Washington Post, while CNN notes that it was also used to prevent measles patients from flying.