Sonoma County health authorities on lookout for measles cases

As the Disneyland-based measles outbreak continues to spread across California and beyond, Sonoma County health officials are working behind the scenes to limit any potential outbreaks here.

New figures released Friday from the state Department of Public Health reveal 68 cases of measles have been confirmed in California, 48 of which were traced to a Disney connection. Ten other cases in other Western states and Mexico have been linked to the Anaheim park or secondary infections traced back to park visitors.

There have been no reported cases in Sonoma, Marin, Napa, Lake or Mendocino counties.

But a trio of cases have been confirmed in three other Bay Area counties: Alameda, San Mateo and Santa Clara.

That makes the outbreak “in our community,” said Sonoma County Deputy Health Officer Karen Holbrook.

“To the extent that our populations travel and go back and forth, I consider this nearby and absolutely of concern for Sonoma County,” she said.

Holbrook sent out a notice to health care clinicians on Jan. 9 to be on the lookout for anyone exhibiting signs of the highly contagious viral disease.

Twenty of the cases have no known connection to anyone who visited Disneyland recently.

“That means it’s out,” Holbrook said. “We don’t know what the exposure was. We have not yet put a ring around this outbreak. That’s of concern.”

When someone is confirmed to have the disease, health care providers typically conduct an interview to document where the person has gone and who they’ve potentially infected in other areas. County health officials in those jurisdictions are then notified, and they in turn try to manage exposure risks.

Holbrook said the county has been notified of a few local residents who have been in contact with infected people elsewhere.

One person was even given a blood test to determine if their blood showed antibodies to the disease, which would indicate they’d been exposed.

Schools, potential breeding grounds for quickly spreading diseases like measles, haven’t yet begun any protocols to stave off a potential outbreak.

Holbrook said her office likely would launch that effort in the event of a confirmed local infection.

After receiving such word from the county, Santa Rosa City Schools Director of Special Services Steve Mizera said school nurses and staff would be notified and notices would be sent home with parents. An automated phone alert may go out as well, he said.

“We’re always watching for it,” he said. “If we think there’s a local outbreak, we’ll move some resources over and then we’d notify the county.”

The good news is that most people in Sonoma County are immunized, Holbrook said.

Although parts of Sonoma County are among the state’s hotspots for parents who’ve chosen not to vaccinate their children against measles and other highly communicable diseases, the number of kindergartners not immunized against measles fell last year, she said.

In some areas of west Sonoma County, 1 in 5 children entering kindergarten have obtained so-called “personal belief exemptions” waiving vaccine requirements, according to past school records. Two Sebastopol-area districts, Twin Hills Union Elementary and Sebastopol Union Elementary, have reported personal belief exemption rates of 40 percent or higher in recent years.

This year, 91.5 percent of all kindergarteners in Sonoma County are adequately vaccinated against measles, Holbrook said.

“We do know there are pockets of under-immunized people in Sonoma County and people who are choosing to not immunize at all,” she said.

Those who are not immunized and are exposed to an infected person are at high risk.

Measles “is the most communicable disease that’s out there,” Holbrook said. “A single case will infect about 18 additional people. If you’re susceptible, it’s highly likely if you’re exposed, you’ll get it.”

Measles is a respiratory disease caused by a virus that spreads in the air through coughing and sneezing. It starts with a fever, runny nose, cough, red eyes and sore throat, and is followed by a rash that spreads all over the body.

About 3 out of 10 people who get measles will develop one or more complications, including pneumonia, ear infections or diarrhea, according to the Centers for Disease Control and Prevention. Complications, which are more common in adults and young children, can include pneumonia or encephalitis, both of which can be deadly.

The virus can remain active in the air of a room for two hours, Holbrook said, double the typical survival rate of most viruses.

The vaccine, consisting of two doses typically given after age 1 and before age 5, is safe, health professionals insist.

Holbrook urged parents who have refused vaccines for their children to re-evaluate their decisions after consulting with licensed health care providers.

Before vaccines became the norm in the 1960s, there were about 39,000 measles cases each year in California. In 2000, the disease was declared eliminated from the United States.

In 2005, there were four cases in the state, all people who were travelers, Holbrook said. Each year since then, there have been as many as 60 cases a year.

You can reach Lori A. Carter at 521-5470 or lori.carter@pressdemocrat.com. On Twitter @loriacarter.