One third of schools vulnerable as measles outbreak spreads

More than a third of western Pennsylvania kindergarten classes had vaccination rates that fell below the level experts said was needed to establish herd immunity last year, leaving them vulnerable to an outbreak as cases pile up in the state.

This was a particular concern as measles, which is considered the most contagious disease, is particularly dangerous for infants and children under the age of four years old, as it can scramble their immune systems and lead to brain swelling. Kindergarteners are most likely to have siblings of that age.

So far, no resident of Allegheny County has tested positive for measles. The one confirmed case in the county came from an out-of-county resident who sought care at UPMC Children’s Hospital in Pittsburgh.

However, the statewide number of cases has climbed exponentially, either doubling or more than doubling four months in a row. Last week, more than 80 cases were confirmed by the Department of Health, nearly matching the total number of cases for the month of July. The state also recognized community transmission in Indiana County.

“We have to recognize that there likely going to be more,” Dr. Amesh Adalja, an infectious disease expert based in Pittsburgh, said. “It will be in Allegheny County, and clinicians here will have to contend with it.”

Adalja credited the fact that it took so long for measles to pop up in Pittsburgh to the area’s relatively high vaccination rates.

However, the rates aren’t high enough. Fewer than 95% of kindergarteners have been fully vaccinated against measles. Many Pittsburgh schools, particularly charter and private schools, have rates below 80%.

While dozens of schools did not report their vaccination rates last year, the lowest one that did – Harvest Baptist Academy in Natrona Heights – fewer than half the kindergarteners were fully vaccinated.

“When you see rates that are 92 or 91 [percent], you might think that’s pretty high. That’s not high enough for measles,” Dr. Adalja said. “Those are all just ripe for the virus to take hold.”

The measles vaccine, given in a series of doses until a child begins kindergarten, is 97% effective, researchers said.

Adalja said in places where there have been outbreaks, such as South Carolina, he’s seen a subsequent rise in the rate of vaccinations.

“They basically forgot what a dangerous disease it could be,” he explained. “There’s nothing really complicated about trying to understand this. It really is the result of lower vaccination rates, and the solution then is just as simple: it’s to increase vaccination rates above 95% and then we stop talking about this.”

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