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Daycare centers are latest hit with measles outbreak

Greg Toppo
USATODAY
Dr. Wendell Wheeler gives vaccinations to Ny-riel Wilson as her mother Briana Steele holds her on Tuesday, Feb. 3, 2015, in South Holland, Ill. Wilson was not vaccinated for measles during this visit because she is too young for that vaccination.

Five infants at a suburban Chicago KinderCareLearning Center are the latest to be diagnosed with measles, part of an outbreak that has sickened more than 100 people in the past few weeks.

Health authorities in Illinois said they anticipated more measles cases, but that there was no known link between the new cases in Palatine, Ill.,and last December's Disneyland outbreak. KinderCare has notified families nationwide that it will now require staff working with children under the age of 15 months to be vaccinated.

The Disneyland outbreak has generated the vast majority of the USA's diagnosed cases so far this year, public health officials say, but about one in 12 can't be traced to the southern California amusement park.

The U.S. Centers for Disease Control and Prevention (CDC) has confirmed at least 102 measles cases in 14 states, not including newly diagnosed cases in Illinois. Of the 102, 94 were related to the Disneyland outbreak, which has sickened dozens of people. The CDC's immunization chief said that some U.S. measles cases this year were linked with travel to Indonesia, India and Dubai.

Among the latest developments:

• The advocacy group Autism Speaks on Wednesday urged parents to get their children "fully vaccinated," saying research over the past two decades has unequivocally concluded that vaccines "do not cause autism." Many parents have opted out of vaccinations following a 1998 study, since discredited, that claimed a link between vaccines and autism.

• The New Jersey Department of Health on Thursday said it is investigating a suspected case of measles that if confirmed would be the first in New Jersey this year. Health Department spokeswoman Donna Leusner said the suspected case involves a 1-year-old baby who not been vaccinated. The child was not in a day care facility and there was "no identified connection" to the measles outbreak at Disneyland. The baby has recovered, Leusner said, but out "an abundance of caution," residents in the building where the baby lives were notified of a potential measles exposure.

• In Santa Monica, Calif., 14 babies were held in voluntary quarantine this week after a baby at Santa Monica High School's childcare center was diagnosed with measles. The center was closed until further notice, district officials said.

The Los Angeles Times, citing state records, said this week that about 1,500 child-care centers in California had a measles vaccination rate of 92% or less. Public health officials recommend a rate of 95% or higher to protect against the disease.

The Times found that the vast majority of centers with lower rates — about 1,100 — are private. In Santa Monica, about 30 out of 45 child-care centers had a measles vaccination rate of 92% or lower, according to 2014 state data.

KinderCare, the USA's largest private provider of early childhood education, told employees that those who work with unvaccinated infants must themselves be vaccinated. In a Feb. 5 letter to parents, the company said it's also keeping unvaccinated infants separate from other children and asking parents to keep their kids home if they're sick.

"As always, we are being vigilant about enforcing our policy of excluding children from care when they are sick," KinderCare spokeswoman Colleen Moran said via email. "We are also working with families and staff members in our centers to double-check and update their immunization records."

Moran said that while vaccination isn't a requirement for children to attend, "we highly encourage parents to speak with their family doctor about immunizations for their children, and we work closely with each family to be sure our immunization records are up-to-date. However, we understand that some children are unable to be vaccinated — for medical reasons and or for religious reasons — and we do not exclude those children from our centers."

In the wake of the outbreak, lawmakers in at least 10 states are debating vaccine-related measures, but in a few cases, proposed legislation would make it easier, not harder, to opt out of vaccines.

In California, three Democratic legislators this week introduced a bill that would require parents to vaccinate their children before entering school unless the child cannot be immunized because of a medical condition. Parents would no longer be able to cite personal beliefs or religious reasons to send unvaccinated children to private or public schools.

"People are starting to realize, 'I'm vulnerable, my children are vulnerable,'" said Sen. Richard Pan, a Democratic pediatrician from Sacramento. "We should not wait for more children to sicken or die before we act."

In a letter, U.S. Sens. Barbara Boxer and Dianne Feinstein called on California to reconsider the exemption policy, saying, "We believe there should be no such thing as a philosophical or personal belief exemption, since everyone uses public spaces."

California is among 20 states that allow for personal belief exemptions and 48 that allow for religious exemptions, according to the National Conference of State Legislatures. Only Mississippi and West Virginia make no vaccine exceptions for religious beliefs.

In Oregon, which had the USA's highest rate of non-medical vaccine exemptions during the 2012-13 school year, according to the CDC, lawmakers have proposed vaccine legislation that would require all parents who are considering opting out to meet with a doctor or watch an informational video before making the decision.

In Washington State, a lawmaker on Wednesday introduced a bill that would require parents to cite more than simply "personal beliefs" to opt out of vaccinations.

But in New York, lawmakers proposed legislation that would widen existing vaccine opt-outs by creating a "philosophical" exemption for those whose opposition is not based on religious reasons. The bill's supporters say many parents might have general concerns about vaccines that are not tied to religious doctrine.

Former First Lady Rosalynn Carter, who co-founded the vaccine group Every Child By Two, said states should stop exempting children from vaccine laws due to their family's "personal beliefs."

"There are things that states can do," Carter said. "They can close the philosophical exemption loop hole. It might help if we could make getting a non-medical exemption more difficult."

Every Child By Two has launched a petition on Change.org, urging states to make it harder for unvaccinated children to attend public school. Some say it's not surprising that the national measles outbreak began in California. The state has long been known for making it easy to get vaccine exemptions, Carter said.

"We have known that there are hot spots, where if someone gets measles, it's going to spread," she said. "California is by far the worst."

Carter has campaigned to increase vaccination rates since the 1970s, when her husband Jimmy was governor of Georgia. Since then, the USA has weathered several large outbreaks of measles. During a 1989 to 1991 measles epidemic, the disease infected more than 55,000 people, hospitalized 11,000 and killed 166.

"It's so sad," Carter said. "Immunization rates go up and down, and you have to start over every time."

Contributing: Liz Szabo in McLean, Va.; Trevor Hughes in Denver; Associated Press

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