a day ago
School's out, but child care providers not letting up on measles precautions
Jun. 7—FARGO — With a measles outbreak in North Dakota continuing to grow, local schools may be off the hook after letting out for summer vacation.
Other organizations, though, must be vigilant, and there's still plenty of opportunity for the virus to spread among unvaccinated children, health experts said.
North Dakota had the highest rate of measles based on population of all states as of June 3,
according to data compiled by the North Dakota Public Health Association.
The state had 4.3 cases per 100,000 residents, or a total of 34 cases thus far in the outbreak.
Dr. Stephanie Grondahl, a pediatric hospitalist at Essentia Health, said
given poor vaccination rates in North Dakota, it's probably not if, but when more cases emerge.
"Kids are going to go places for the summer and there are going to be exposures, and with how contagious it is, it will spread," she said.
The Boys & Girls Clubs of the Red River Valley provides child care to around 1,100 school age children at 16 licensed sites during the school year, CEO Robin Nelson said.
Come summer time, about 600 children are served at nine sites.
Just like schools, child care providers must keep immunization records on file for enrolled children, she said.
Her organization has taken an extra step, she said, to compile lists of children who have received the measles, mumps and rubella or MMR vaccine and those who haven't due to medical, philosophical or religious reasons.
The list is kept internally so the organization can be more prepared for various circumstances.
"We have to control what we can on our end," Nelson said.
She proactively sent an email to families a few weeks ago, spelling out the policy relating to children who have not received the MMR vaccine.
If such a child has been exposed to measles, either on site or elsewhere, they are excluded from child care for 21 days, unless they get an MMR vaccine within 72 hours of exposure, Nelson said.
Measles was a common childhood illness before the MMR vaccine was developed to prevent it.
It's made a comeback, however, in certain areas where immunization rates are low.
The virus is highly contagious, lingering in the air for several hours, and usually doesn't cause long-term medical issues.
However, measles can be serious and even deadly, especially for children younger than age 5 and people whose immune systems are compromised.
Dr. Avish Nagpal, director of infection prevention at Sanford, said he expects to continue to see smaller outbreaks of measles as the virus finds pockets of children who are not immunized.
"We are still early in the outbreak. I do anticipate that we'll see more cases as a slow churn," Nagpal said.
Grondahl said it's recommended that children get their first MMR dose after they turn 1, and a second dose between ages 4 and 6.
Nagpal said it is possible for an infant to get their first dose between six and 12 months, but it won't count toward the normal vaccination schedule.
He also recommends women of childbearing age receive the MMR vaccine because they cannot receive it once they become pregnant.
For the very youngest children, Grondahl had this advice.
"I think from a very personal standpoint, if I had a child who was unimmunized, I would probably try to keep them away from large crowds, especially in areas where we know that there are active outbreaks happening," she said.
