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Central Coast health officials "heightening county surveillance" for measles

A 3D graphical representation of a measles virus.

Following a measles quarantine of hundreds of students at Los Angeles universities, Central Coast health officials are on high alert, they say. Since January, over 700 cases of measles have been reported in 22 states.

In the past eight years, Santa Barbara County public health officials said, they've seen only one case of measles—in 2016. San Luis Obispo County had one case in 2018. Public health staff in both counties say they are working with healthcare providers to keep an eye out for any new cases.

“As a result of the uptick in measles cases, we are heightening our county surveillance,” said Jackie Ruiz, a health educator for Santa Barbara County. “This includes raising awareness amongst our local healthcare providers about identifying measles and what to do if there is a suspected case.”

Part of this means alerting providers on what to look for, said Rick Rosen, deputy health officer for San Luis Obispo County. Rosen said measles often presents with a fever and rash around the head, but there are other symptoms as well.

“They refer to measles as featuring the three Cs: cough, coryza—which just means runny nose—and conjunctivitis, or red eye,” Rosen said.

But according to University of California Santa Barbara Medical Director Ali Javanbakht, this can make measles difficult to spot.

"The problem with measles is that for the first four days, it looks just like any other flu-like illness with fever, runny nose, cough, and red eyes,” Javanbakht wrote in an email. “However, it is still transmitted during this window, so people with measles wind up having a few visits to healthcare facilities before the characteristic rash develops and the diagnosis is made."

Javanbakht said UCSB is considering having students who come to the health center with symptoms wear medical masks as a precaution.

"As you can imagine, with an institution of our size, comprising of 24,000 students and about 8,000 or so staff, all in relatively close proximity, an outbreak of a highly contagious disease such as measles could pose a serious problem,' Javanbakht said. "We're trying to strike a balance between being responsive, but also not causing a panic and overwhelming our resources."

Javanbakht said as of 2017, UCSB requires every new student to show proof of being vaccinated for measles, chicken pox, tetanus/whooping cough, and meningitis.

“This means that about half of our student population should have a high enough level of immunity,” Javanbakht said, adding his department is working on messaging for students to check their own immunity status.

Cal Poly spokesperson Matt Lazier said the San Luis Obispo university follows California State University immunization requirements. Measles vaccination is among the immunizations required to attend Cal Poly.

“There is a waiver or exemption policy in place for students who are medically unable to obtain immunization; because of an allergy; who object on personal/religious grounds; or who are enrolled solely in a distance learning program,” Lazier wrote in an email. “Per a recent revision to CSU policy, beginning in academic year 2020/21, only exemptions on medical grounds will be allowed.”

Lazier said the majority of Cal Poly students are immunized.

“The university’s health and wellbeing department is reviewing its database to determine how many current students have not been immunized against measles,” Lazier said.

San Luis Obispo County health officials said they have stock of measles vaccinations.

“We are ensuring there is plenty of vaccine available and at this time, there is no shortage,” Ruiz said. “We do have a mechanism to reach out to local healthcare partners and, if needed, the state for additional vaccine.”

Rosen said his department was on a statewide conference call this week with health agencies to help prepare.

"[Measles] is certainly at the front of our minds," Rosen said. “It’s making sure we are prepared in the event that we get ca ase or possibly an outbreak. We verified we have the vaccine, so we’re prepared on that front. The lab is prepared. But other than that, there’s not much else we can do at this point.”

Regarding the effectiveness of the vaccine depending on the year you received it, there have been questions about who should get re-vaccinated.

“You should only get a booster if you are planning international travel or have been exposed to a known case,” Rosen said, adding that those who aren’t sure of their vaccination history and have either travelled internationally or been around international travelers are encouraged to see a healthcare provider.

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