It’s been 15 years since Wyoming saw a case of measles. Before that, another 10 years. The highly infectious, sometimes fatal disease was considered eliminated in the state and nation in 2000. But in the past several weeks, measles has been found in three Wyoming counties. The state health department thinks it might be spreading in one.
Nationwide this year, measles has killed three people, and 13% of people who’ve caught it ended up in the hospital, according to the Centers for Disease Control and Prevention (CDC).
Wyoming Public Radio’s Nicky Ouellet spoke with state epidemiologist Clay Van Houten about where measles has been found in the state, how our herd immunity is doing and how you can protect yourself and your family.
Editor’s Note: This conversation has been lightly edited for clarity and brevity.
Nicky Ouellet: Wyoming has identified seven cases of measles. Can you just share what's known about these cases?
Clay Van Houten: Our first case was identified in Natrona County. We did not find the source or the likely source of infection for that child, which was a little bit concerning.
We then had a second case in Niobrara County. Again, really couldn't find the source of infection for that child either. I was a little bit worried that we might see more cases in those areas just because we couldn't identify the source. But I think we're far enough out now that we likely aren't gonna see any more in those areas, at least related to those two cases.
Now in Carbon County, we have five cases. The first case there, we pretty quickly ascertained that that person was exposed outside of the country. Since that first case, the additional four have all had some link to a known case.
NO: Is there any indication from these cases that measles is spreading in Wyoming?
CVH: I think in Carbon County for sure. I would expect us to see more cases reported from Carbon County and identified there.
NO: Measles can be a very, very serious infection. Without breaking HIPAA or invading people's privacy, what can you share about how they're doing?
CVH: The cases have recovered or the more recent cases, they're still sick. We've been really, I think, blessed that none of the cases have been hospitalized thus far, which you can see quite a high percentage of measles cases that require hospitalization as a consequence of the infection. But so far, everybody's doing well and no hospitalizations, which is great.
NO: And the folks who are catching it, have they been vaccinated against the illness?
CVH: Our most recent case in Carbon County was previously vaccinated. Unfortunately, that individual had some underlying health conditions that created an immunocompromised situation where they were much more susceptible to infection. They had been vaccinated, but immunocompromised and unfortunately developed illness.
The others were all unvaccinated.
NO: How does the health department find these cases? Are people coming into the hospital or a clinic situation?
CVH: Yeah, that's exactly what's been occurring. Measles can be really tough to diagnose at first. The first set of symptoms that someone can get [is] generally a pretty high fever, runny nose, cough, some red eyes. Of course, those symptoms can look like a lot of different things.
Then a few days later, the patients will develop a rash. The rash starts at the hairline, starts moving down the body out to the limbs, and that's really when it becomes pretty indicative of measles.
NO: If someone is experiencing some kind of symptoms and they're concerned, what's the best next steps for them?
CVH: Please call ahead to your healthcare provider before you go in to see them. We've seen this now with multiple cases of ours – and it's of no fault of anybody's, those first symptoms look like a lot of different diseases. If you're suspecting measles at all, call ahead, just because it is so contagious. They can do some things within those clinics to isolate you in a room, keep you away from other susceptible people in the clinics or ER.
Editor’s note: The state health department issues alerts in instances where people may have been exposed to measles while out in public. Those alerts can be found on the department’s measles page.
NO: I'm thinking about folks in Carbon County and what actions can people take to protect themselves and their families against measles?
CVH: The first and biggest is to speak with our healthcare providers about getting vaccinated if they're not already vaccinated. Or if they are unsure whether they were vaccinated in the past, we recommend anybody that has questions about that [to] contact their healthcare provider and work through those questions and make sure that [if they] need the vaccination, it's right for them.
It's a very high protection rate. Two doses usually protects about 97% of people. It's a pretty good vaccine and it does confer lifelong immunity.
Certainly, when we're talking to the cases, we work really hard with them to make sure they're not out and about while they're infectious. That also helps protect people. And then having enough people vaccinated, that can protect everyone.
NO: So how many folks in Wyoming have had this vaccine and is something like herd immunity gonna help us against measles?
CVH: Yeah, certainly herd immunity does help. The consensus on the percentage of the population that you need vaccinated to protect against measles to develop this herd immunity is about 93%.
NO: Oh wow, that’s high.
CVH: Yeah, it is high. But fortunately, that's about right where we are currently in Wyoming. We're just a little bit above 93%.
NO: Are you noticing a drop-off rate in people getting MMR vaccine?
CVH: I think overall, the vaccine rates have dipped a little bit. The last two years of Wyoming data looks like we've remained pretty steady, which is good. We're still doing really well with our vaccination rates with some of these key childhood diseases that we wanna protect against.
NO: I hate to go here, but I'm curious: What are you worried about? What's the worst-case scenario in your mind?
CVH: Oh gosh. I think a worst-case scenario is we have someone who's severely ill and requires prolonged hospitalization, or heaven forbid, we have a death related to this. That's my worst fear with this disease. It's pretty serious and it's so contagious. [It] spreads very easily [and] can remain in the air for a couple of hours after the person leaves a room.
NO: What about for healthcare systems though? Are we facing a situation where we could see local clinics, hospitals inundated and not be able to meet everyone who needs care?
CVH: No, I don't think we're in a situation like that. Certainly not like we were with COVID and even sometimes get with seasonal flu.
Part of that is we're pretty well vaccinated in Wyoming, so we've got a small number of people who are still susceptible, and even though it's circulating among those people, I don't think it's enough to inundate a clinic or a hospital.
