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Sunday, August 27, 2017

Health officials declare end of measles outbreak

Response required extensive collaboration among many partners

State health officials today declared an end to the measles outbreak of spring and summer 2017.

The outbreak that eventually sickened 79 people, mostly children under 10 years of age, began when the first case was identified April 11. The last case was identified on July 13. Under standard public health practice, the outbreak can be declared over if there are no new cases identified for 42 days. The incubation period for measles is 21 days, meaning that's how long it can take for someone who has been infected with measles to show symptoms. Health officials wait two incubation periods (42 days) out of an abundance of caution.

The outbreak was the largest measles outbreak in Minnesota since 1990 when 460 people became ill and 3 people died. In the 2017 outbreak there were:

  • More than 8,000 people exposed to measles
  • More than 500 people asked to stay home from school, child care or work because they were potentially infectious (unvaccinated and exposed to someone infectious)
  • 22 people hospitalized
  • 73 cases under 10 years old
  • 71 of the cases unvaccinated for measles
  • 70 cases in Hennepin County, but also three in Ramsey County, four in Crow Wing and two in Le Sueur counties.

Bringing the outbreak to an end required a major public health and community response, health officials said. It involved significant resources of staff time, energy, expertise, laboratory capacity and outreach to the affected communities. It required significant collaboration among state and local public health agencies, health care systems, schools and child care centers and even work places, as well as the Somali community.

The Minnesota Department of Health (MDH) estimated its costs for the outbreak response were more than $900,000 and Hennepin County estimated its costs at about $400,000.

Minneapolis' Somali community was hit particularly hard by the outbreak, where 64 of the 79 cases occurred, mostly in unvaccinated individuals. Vaccination rates for measles, mumps and rubella (MMR) vaccine at the start of the outbreak hovered around 42 percent among Somali Minnesotan 2-year-olds. That allowed the virus to spread more easily among children in the community.

"This outbreak showed that preventing disease requires all of us working together," said Minnesota Health Commissioner Dr. Ed Ehlinger. "Public health is a community, collective endeavor. It's what we as a society do together to ensure the conditions in which everyone can be healthy."

Commissioner Ehlinger said MDH is committed to sustaining the momentum gained from working so closely with so many leaders and partners in the Somali community over the course of the outbreak to improve not just vaccination rates but other conditions affecting the health of the community.

The department will be actively engaged in a number of activities to help prevent future outbreaks, Ehlinger said. Those efforts include:

  • Partnering with professional medical organizations to assist in developing effective communication strategies when working with vaccine-hesitant parents.
  • Continuing to engage the community through an advisory group of Somali Minnesotan community member
  • Amplifying the training of community members, such as Somali health professionals, interpreters, doulas and faith leaders, that have an influential role within the community, both in regards to vaccine-preventable disease and autism.
  • Amplifying outreach efforts to address autism questions and linking parents to autism spectrum disorder resources.
  • Amplifying outreach and education efforts on vaccine preventable diseases including MMR vaccine safety. 
  • Continuing to work closely with child care centers to educate center directors and parents.
  • Continuing to work closely with schools with higher rates of conscientious objectors for MMR.
  • Continuing the work through the imams.

The outbreak also demonstrated that the public health interventions of rapid case identification, monitoring and follow-up, vaccination and exclusion, worked, health officials noted.

"Seventy-nine cases is 79 too many, but when you consider how many people were exposed and how many were susceptible, it's clear that the interventions helped keep the outbreak from being even worse," said Kris Ehresmann, director of infectious disease for the Minnesota Department of Health. Except for vaccination, those intervention tools were not available to public health during the 1990 outbreak, she noted.

Ehresmann said it was also clear from the course of the outbreak that the measles virus is very effective at finding the unvaccinated, but also that high vaccination rates among the entire population protect the vast majority of people in Minnesota.

"We need to remain vigilant," Ehresmann said. "As long as measles exists elsewhere in the world and there are clusters of unvaccinated people here, another outbreak could happen. Measles is just a plane ride away. We must maintain an adequate public health infrastructure and response capability to ensure we're prepared for the next threat."

Monday, August 14, 2017

Health officials complete investigation of E. coli infections

No source identified; awareness, precautions urged to prevent infections

Minnesota Department of Health (MDH) epidemiologists have completed their investigation into the E. coli bacterial infections that seriously sickened two Wright County siblings but were not able to identify a specific source.

The infections caused hemolytic uremic syndrome, a serious form of kidney failure, in the children. This severe complication resulted in the death of one of the children; the other is recovering at home. The children were sickened with a strain of Shiga toxin-producing Escherichia coli, or STECknown as STEC O145, as well as an undetermined type of STEC.

Disease investigators considered all known potential sources of E. coli, including typical sources, which can include foods such as ground beef, leafy greens and raw milk; swimming; person-to-person transmission in families or daycares; and farm animal contact, such as at fairs or petting zoos.

"Unfortunately, we were not able to identify the source of the children's infections," said MDH State Public Health Veterinarian Joni Scheftel. "In particular, we did not find a connection with a petting zoo that the children visited, despite extensive testing of the animals." To date there have been no additional cases of people infected with the same strains of E. coli. "However, we will continue to monitor for cases that may help establish a link and/or source," Scheftel said. 

Health officials said it's important to be aware that germs like Shiga toxin-producing E. coli can be found in food and animals, even healthy ones. They urged people to continue everyday precautions to help prevent infections. Cook meats to proper temperatures and check doneness with a meat thermometer, avoid contaminating ready-to-eat foods with the juices from raw meat, wash raw fruits and vegetables before eating them, wash your hands after using the bathroom, before you eat and after being in contact with animals or their environment.

Thursday, July 13, 2017

Learn about health improvement through Library programs

Dakota County Library is hosting programs in July and August for health and wellness. Learn the importance of treating hearing loss, solutions for aging in place at home, getting better sleep, and how to eat healthy. 
 
Check out a list of upcoming programs below. For more information and to register, visit www.dakotacounty.us/library or call 651-450-2900.
 
Hear for the Health of It
Learn about the importance of treating hearing loss, how and where to get an accurate diagnosis, and how to effectively deal with hearing loss. Presented by the Minnesota Department of Human Services.
Registration required.
Wed, July 19, 10:30–11:30 a.m.
Galaxie Library
 
Aging in Place
Explore solutions that help people stay in their homes as they age — from simple DIY fixes to more involved improvements — using the AARP "HomeFit" Guide. Bring photos, sketches or plans of areas
of concern to discuss. Presented by licensed architect and Certified Aging-in-Place Specialist,
Gene Nicolelli.
Thu, Aug. 3, 6–8 p.m.
Galaxie Library
 
Secrets for Sleep
Learn important facts about sleep, the impact of poor sleep, and how to address sleep problems. Gain practical tips on how to get the most restful sleep. Presented by Lori Kearney of Mindful Health with Lori.
Wed, Aug. 9, 6:30–8 p.m.
Wescott Library
 
Eating for Energy: Fuel for Your Day
Discuss how food can energize or drain you, and learn about the relationship between sugar and mood swings. Learn about bio-individuality and how to make good food choices to maximize energy and vitality. Presented by Lori Kearney of Mindful Health with Lori.
Thu, Aug. 10, 6:30–8 p.m.
Burnhaven Library