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Rates of unvaccinated children rise in Maryland and nationally

A patient in St. Mary’s County does not have measles after all, according to the local health department.

The Maryland Department of Health had initially reported the case as positive to the St. Mary’s County Health Department, which in turn alerted the public in hopes of reducing people’s risk of exposure. However, subsequent testing by the Maryland State Laboratory determined that the individual did not have measles, officials said Tuesday.

The patient was isolated within hours after an evaluation at MedStar St. Mary’s Hospital Emergency Department in Leonardtown on Sunday, according to the St. Mary’s County Health Department.Officials feared that others in the emergency room around the same time could have been exposed to the disease.

Most Marylanders aren’t at risk for contracting measles. And compared with other states, a relatively low percentage of Maryland children are not vaccinated against the disease. But the rate of unvaccinated children entering kindergarten in Maryland has nearly doubled during the past decade amid a nationwide trend against vaccination, leaving more people at risk of contracting the potentially life-threatening disease.

“Unvaccinated rates across the country are increasing, and to me it’s mind-boggling because this is a vaccine that prevents death — period,” said Dr. Aaron Michael Milstone, associate hospital epidemiologist for Johns Hopkins Hospital.

Measles is highly contagious, and people who are not vaccinated against the respiratory virus are at risk of catching it. The airborne disease spreads through coughing and sneezing, and measles microbes can live in the air for up to two hours after an infected person has left the area.

“Measles gets in the air and can stay in the air,” Milstone said. “Someone walks through a room that has measles and you walk through that room an hour later, you’re at risk for getting the virus.”

The first phase of symptoms — including a fever of more than 101 degrees, runny nose, watery eyes and a cough — typically develops one to two weeks after a patient is infected. Three to five days after initial symptoms appear, patients typically contract a rash that spreads from the face to the rest of the body.

Children under age 5 and adults over age 20 are more likely to suffer measles complications, some of which can lead to hospitalization or death. Ear infections and diarrhea are common complications, but one in 20 children contract pneumonia — the No. 1 killer of children with measles — and one in 1,000 kids develop brain swelling (encephalitis), which can leave them with intellectual disabilities, according to the U.S. Centers for Disease Control and Prevention.

One or two of every thousand children that get measles will die from it, the CDC says.

Most children in the U.S. are vaccinated with a measles-mumps-rubella (MMR) vaccine, with one dose from 12 to 15 months of age, and a second dose from ages 4 to 6. Adults who are not immune can also receive the vaccine.

Every state allows medical exemptions to standard vaccinations like MMR for people with conditions that compromise their immune systems. And most states also allow parents to obtain religious or philosophical exemptions to vaccinating their children.

Maryland provides for medical and religious exemptions.

The MMR vaccine is one of seven vaccines required for school-aged children in Maryland for the current school year. Students were also required to be vaccinated for conditions including polio, hepatitis B and chickenpox.

Among all states, Maryland had the 12th-lowest percentage of kindergartners who were unvaccinated for at least one condition during the 2017-2018 school year, the most recent year for which data were available. At that time, 1.5 percent of children enrolled in kindergarten were not vaccinated for at least one condition. Among Maryland kindergartners, 0.9 percent were not vaccinated because of a nonmedical exemption, and 0.6 percent of kindergarten students were medically exempt from vaccination.

Though the rate of unvaccinated children entering kindergarten in Maryland remains relatively low, it has nearly doubled since 2009, when the rate of unvaccinated kindergartners in the state was 0.8 percent, according to CDC data.

States with the highest rates of unvaccinated kindergartners for the 2017-2018 school year included Oregon (7.6 percent), Idaho (7.1 percent) and Alaska (7 percent), according to the CDC. Rates of unvaccinated children have been steadily growing for several years in those states.

Other areas have seen their population of unvaccinated children skyrocket. In Washington, D.C., for instance, the percentage of unvaccinated kindergartners jumped to 5 percent for the 2017-2018 school year, up from 1.1 percent the year prior.

“It’s truly a shame that people who aren’t vaccinating their kids aren’t thinking about what this is doing to everyone else,” Milstone said. “They’re not thinking about the risk that they pose to other children.”

Since the start of the year, at least 206 measles cases have been confirmed in 11 states, according to the CDC. Six outbreaks of at least three cases have been reported in New York, Washington, Texas and Illinois, according to the CDC. Those outbreaks are related to international travelers, the CDC said.

At least one case of measles was confirmed in Maryland last year.

St. Mary’s County has set up a local hotline to take questions and concerns from the community.

smeehan@baltsun.com

twitter.com/sarahvmeehan

Baltimore Sun reporter Christina Tkacik contributed to this article.

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