The first confirmed case of measles in Indiana in five years has showed up in Lake County and the state is responding with three vaccination clinics Wednesday to help prevent the spread.
The Indiana Department of Health said the first case of measles in the state since 2019 was confirmed in a Lake County resident, according to a release. The risk to the public is low, but IDOH continues to investigate the case along with local public health officials.
No other information about the case will be released to protect patient privacy.
The Indiana Department of Health is offering three free MMR vaccination clinics next week for individuals at least 1 year old. The clinics take place from 3 to 7 p.m. Wednesday at the Gary Health Department at 1145 W. Fifth Ave., in Gary; East Chicago Health Department at 100 W. Chicago Ave., in East Chicago; and the Jean Shepard Community Center at 3031 J.F. Mahoney Drive in Hammond.
Dr. Chandra Vavilala, Lake County’s health officer, and Marianne Kundich, the Lake County Health Department nursing supervisor, said the office was informed there was one proven case of measles in Lake County diagnosed within the past two days.
Vavilala said the health department has been collaborating with IDOH and the health departments in East Chicago and Gary regarding the case.
“This is something concerning,” Vavilala said, adding, “I would not say we are completely shocked by something like this.”
Lake County has some of the lowest overall vaccination rates in the state for children 3 and younger. Improving immunization rates was one of the core services the health department was working to address with some of the $4.8 million in Health First Indiana funding the state legislator funneled to the county to improve overall health outcomes.
Vavilala said the health department has been conducting monthly free vaccination clinics where residents can get caught up on any missing immunizations they have and receive vaccinations for COVID, the flu, RSV and shingles, among other vaccinations. The first two clinics were in Hammond. A third clinic is set for March 20 in Lake Station. These clinics are in addition to the MMR-specific vaccination clinics taking place Wednesday in response to the positive measles case.
“Lake County definitely lags behind in immunization rates,” Vavilala said.
The COVID-19 pandemic and ensuing lockdown limited information about and access to vaccinations and hurt immunization rates. The immunization rate improves as children get older and catch up with some missed vaccinations.
Dr. Tae’Ni Chang-Stroman with Kids First Pediatrics on 30 said he has been practicing medicine for 29 years.
“I personally have never seen a case of measles. I’ve read about it. I heard about it. I’ve never seen it,” Chang-Stroman said.
The disease, previously once on the verge of eradication, is so rare, the doctor said he would have to brush up on symptoms to be aware. His practice has a mandatory vaccine policy, so he does not expect to see the disease within his practice.
Paranoia about vaccines has prevented a growing segment of families from vaccinating their children.
Vaccine hesitancy stems from mistrust that began after false information spread in the mid-1990s by a doctor from England who published a paper blaming the Measles, Mumps and Rubella, or MMR, vaccine for autism. The paper was discredited and the doctor lost his license to practice in his country. Since then, paranoia about the vaccine has meant rates for MMR vaccination have not been the greatest.
Vaccines are never 100%, Chang-Stroman said. A certain amount of people will not develop immunity. Herd immunity is only reached when about 96% of the population receives the vaccine.
“Those are the people we are trying to protect,” he said.
Chang-Stroman said he implemented the mandatory vaccination policy at his office because he realized that no matter what he said to people who chose not to vaccinate their children, he would not change their minds.
“I was wasting my time. There are no two ways about it,” Chang-Stroman said.
To protect his patients, including some who had received transplants and who were susceptible to diseases, everybody who comes into the office has to follow the vaccination schedule as written. Chang-Stroman said people who do not want to vaccinate their children do not have to come to the office.
There isn’t a cure for measles. The treatment is to provide support to a patient including oxygen and fluids while they try to wait the infection out.
“The best medicine is vaccination,” Chang-Stroman said.
When people call the office and say their child is running a fever, if that child is fully vaccinated, he can be about 99% sure that the patient is going to be OK. Before vaccinations, diseases like measles, mumps and meningitis, among others, could seriously harm a child.
“As less and less children are getting the MMR vaccine, there are more and more chances of outbreaks,” he said.
Measles is highly contagious. The disease circulates in the room for hours after an infected individual has been there, he said.
“Measles is easily spread and can be serious, especially for young children. About one in five unvaccinated people in the United States who get measles is hospitalized, and 90% of unvaccinated people who are exposed to measles will become sick,” said State Health Commissioner Dr. Lindsay Weaver. “This case is a good reminder that you are at risk if you haven’t been vaccinated.”
Measles is a highly contagious respiratory disease caused by a virus. It is rare in the U.S. due to the widespread availability of the MMR vaccine, but visitors from other countries or U.S. citizens traveling abroad can become infected, particularly before or during travel.
As of Feb. 15, the Centers for Disease Control and Prevention (CDC) reports 20 confirmed cases of measles in the United States this year.
More than 93% of people who receive a single dose of MMR will develop immunity to measles, and more than 97% will be protected after receiving a second dose. Two doses of the vaccine are needed to be fully protected. Individuals are encouraged to check with their healthcare providers to ensure vaccinations are up to date. Individuals born before 1957 are presumed to be immune to measles.
Children are routinely vaccinated for measles at 12-15 months, and again at 4-6 years of age before going to kindergarten, but children as young as 6 months old can receive the measles vaccine if they are at risk. Because some children are too young to be immunized, it’s important that those around them are vaccinated to protect them.
Measles begins with a fever, cough, runny nose and red eyes usually about 7 to 14 days after exposure to measles but can occur up to 21 days. The fever increases and can get as high as 105 degrees.
Tiny white spots (Koplik spots) may appear inside the mouth two to three days after symptoms begin. Then two to four days after symptoms begin, a rash starts on the hairline and face. It spreads down the back and trunk, and then extends to the arms and hands, as well as the legs and feet. After about five days, the rash fades in the same order in which it appeared.
Because measles is so easily spread, a single case is considered an outbreak. When infected people sneeze or cough, droplets spray into the air. Those droplets remain infective in the air and on surfaces for up to two hours.
What you can do
If you are experiencing the symptoms of measles, stay home and call your healthcare provider right away before going to the doctor’s office. Be prepared to describe your symptoms and alert your doctor if you think you have been in contact with an infected person. If you are ill with measles, stay home and away from others, especially unvaccinated infants, people with diseases affecting their immune systems and pregnant women.
cnapoleon@chicagotribune.com
