A highly contagious disease that was all but wiped out in America decades ago has returned, and public health officials across the state are closely watching outbreaks in three Portland-area counties.
Among those monitoring the outbreaks in Multnomah, Clackamas and Marion counties are officials at Yamhill County Health and Human Services, especially as youngsters prepare to return to local schools in a few weeks. Officials there advise caution and taking action if parents or guardians suspect their child has been exposed to the malady.
“(Parents should) contact their child’s health care provider immediately if you think you or your child have been exposed to measles,” Jason Henness, behavioral health director at Yamhill County HHS, said.
Henness further advised, however, that parents also take precautions to not spread the disease if indeed their child is infected.
“Please call the provider’s office first, don’t just show up at the clinic,” he said. “Measles is very contagious and can be dangerous, especially for babies and young children.”
Yamhill County last experienced a measles outbreak in 2018, and Henness advised parents and guardians to contact their health care providers for recommendations on protecting youngsters from the disease.
“Keep your child home if they are feeling sick and also if they have had a fever within the last 24 hours,” he said.
A range of symptoms
A respiratory disease, measles can be spread when an infected person breathes, coughs, sneezes and contacts surfaces. Symptoms range from a red rash that appears on the face and neck, to fever, swollen and watery eyes and other cold-like afflictions. Those who have contracted the disease have also been known to suffer from diarrhea, ear infections, pneumonia and, in rare cases, a swelling of the brain that can lead to a permanent disability called encephalitis.
While anyone who has had measles as a child is generally immune, the remainder of the population is susceptible to the disease, particularly toddlers and infants with undeveloped immune systems.
Disease emerges at the worst possible time
With students set to return to school in a few weeks, public health officials are urging parents and guardians “to get their children vaccinated against the highly infectious virus before classes begin,” a release from the Oregon Health Authority said.
Dr. Paul Cieslak, OHA medical director for communicable diseases and immunizations, said state and county epidemiologists have seen waves of measles cases since about mid-June and this represents the largest outbreak since 2019, when 28 cases were linked to a larger outbreak in Clark County, Washington.
“Before 2019, you have to go all the way back to the early 1990s to see case counts this high,” Cieslak said. “The reason is we maintained very high vaccination rates and very high population levels of immunity. Unfortunately, we’ve seen an erosion in the percentage of people who are getting vaccinated against measles.”
The phenomenon of parents employing exemptions to school vaccination requirements has exacerbated the problem and produced near-perfect conditions for a large outbreak.
Before 2019, Cieslak said, only about 1% of kindergarteners were exempted from vaccinations. Since then, that number has increased exponentially, with an 8.8% exemption rate reported in the 2023-24 school year.
“In Clackamas County, as in other Oregon counties, pockets of unvaccinated people raise risks of infection in communities where they live,” Clackamas County Health Officer Sarah Present said in the OHA release. “That’s why the counties reach out to every case that’s been identified and try to determine exactly where they’ve been while infectious.”
Cases so far contained in three counties
As of Aug. 15, a total of 28 confirmed cases of measles have been reported in Clackamas, Marion and Multnomah counties, all among unvaccinated individuals. Two individuals have been hospitalized.
Ten of the cases are in children 9 years old and younger; 10 cases have stricken people age 10 to 19; and five cases are among adults 20 and older. Marion County has reported the most cases with 19, followed by Clackamas County with eight and Multnomah County with one.
Monitoring cases and encouraging vaccinations
While the OHA and counties are closely monitoring the situation, officials face an uphill battle in trying to contain a measles outbreak.
“Someone with measles can spread the virus for up to four days before the telltale rash appears, and their symptoms may be mild during that time,” Present said. “As a result, the counties and OHA have been sharing information about specific locations that cases are known to have visited, so we can let members of the public know they may have been exposed to measles.”
Widespread vaccinations, Present added, are the only sure way to curb and outbreak.
“(Present) noted that since measles is so contagious, an estimated 95% of a population needs to have received two doses of measles vaccine to be able to protect the most vulnerable members of the community via community or ‘herd’ immunity,” the release said.
The upside of getting vaccinated, the OHA concluded, is that it will help families “avoid the burden of having to isolate at home for several weeks if they are exposed to measles.”
And there is a legal aspect to the outbreak as well. State law requires that an unvaccinated person exposed to the virus be excluded from school or child care “during the period when they could become sick, which is usually for 21 days after exposure.” The exclusion can be extended as well if more measles cases emerge.
“It’s really an important time to make sure students and their families are up to date on vaccinations as we go into the new school year,” Present said.
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