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Chicago-area measles cases put spotlight on day care centers

February 6, 2015

CHICAGO (AP) — Measles infections in five babies at a suburban Chicago day care center reveal a potential weak link in public-health efforts to contain the disease, authorities said Friday, explaining that infants who are too young to be vaccinated and in close quarters are among the most vulnerable to the virus.

“They’re sort of like the canary in the mine,” said Dr. Tina Tan, an infectious disease specialist at Chicago’s Lurie Children’s Hospital.

The cases are among more than 100 nationwide this year, most of them linked with a Disneyland outbreak.

Most U.S. measles cases in recent years stem from contact with someone who has been abroad, since the disease is still common in many countries. The highly contagious virus was declared eliminated in the United States in 2000, but U.S. cases have been reported every year since then, including more than 600 last year.

State regulations in Illinois and elsewhere generally require vaccinations for older children in day care centers, but measles shots are not recommended for children under age 1. And like most states, Illinois does not require vaccinations for day care center staffers.

“Unfortunately, there is no requirement. But this is on our radar,” said Melaney Arnold, spokeswoman for Illinois’ Department of Public Health.

Ten other young children at the suburban center were exposed and were being monitored for symptoms.

This year’s cases also include an infant at a Santa Monica, California, day care center that closed temporarily this week. Fourteen infants from that center have been quarantined at home for three weeks.

Dr. Julie Morita, acting commissioner of Chicago’s public health department, said this year’s outbreaks highlight the major reasons for immunizations against a rare disease. The shots are not just for self-protection. They also provide what experts call “herd immunity” — protection for those too young or too sick to be vaccinated, including infants in day care.

Measles can cause a cough, runny nose and rash. Infants are vulnerable to rare but dangerous complications that include pneumonia, deafness, permanent brain damage and death.

Illinois authorities were seeking the source of the day care outbreak but said there was no evidence it’s linked with the Disneyland cases. Possible sources include unvaccinated older children or adults who recently traveled overseas.

The government recommends the first dose of measles vaccine for children aged 12 months to 15 months, with a second dose before the start of kindergarten, when children are about five years old. The shots are not advised for younger children, mainly because the vaccine is less effective for them. But it can offer partial protection, and the outbreak has led some experts including Tan to suggest that concerned parents discuss possible infant immunization with their pediatricians.

Most parents choose to vaccinate their older children, but health authorities and ethicists are concerned about clusters of families who reject vaccines for personal or religious beliefs, and the risk they pose to those who cannot be vaccinated.

“There is clearly a very weak link in the system or else we wouldn’t be having these outbreaks,” said Lawrence Gostin, an ethicist and public law specialist at Georgetown University.

Public health authorities “absolutely should be looking more closely” at how to protect unvaccinated children in day care, through vaccine requirements for staff or fewer exemptions for children of parents who oppose vaccines, Gostin said.

KinderCare Learning Centers, which runs the Palatine, Illinois, center where the five infected infants were enrolled, announced this week that it will start requiring measles vaccinations for staff members at its 1,500 locations nationwide who work with children under age 15 months.


Associated Press video journalist Alex Sanz in Atlanta contributed to this report.


CDC and measles: http://www.cdc.gov .

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