Health officials in eastern Ohio are grappling with a measles outbreak, the largest in the US since 1996, linked to an Amish mission trip to the Phillippines. From The Coshocton Tribune:

Sixteen confirmed cases of the highly contagious disease have showed up near the Knox County village of Danville, less than 35 miles west of Coshocton County. Four members of an Amish community there recently traveled to the Philippines and are believed to have infected family members with measles upon their return.

The travelers were not vaccinated against measles, a disease characterized by a bright rash, and the Philippines is grappling with a measles epidemic that has afflicted about 20,000 people there, killing at least 50.

Knox County, bordering Holmes County on the southwest, is home to all or parts of six Amish settlements.

As you probably know, Amish are less likely to be vaccinated than the average American. According to reports, Knox County Amish families have “flocked to clinics this week” for inoculation against the disease.

A number of area counties, including Ashland, Holmes, and Knox, have been holding clinics and encouraging residents to be immunized.

We don’t hear much about measles because of the effectiveness of vaccines (see CDC recommendations on measles vaccination), though there are still over 100 reported cases each year. Interestingly, if you were born before 1957, you are likely (though not necessarily) considered immune.

Measles Dangers

Only about 0.1% of those infected with measles will die from it, though fatality rates can be much higher in less-developed countries. The disease is highly contagious and can cause complications such as ear infection and pneumonia.

Babies and young children are at particular risk. Measles in pregnant women can cause miscarriage, premature birth, and low birth weight.

In the case of the Amish, the measles were apparently first misdiagnosed as Dengue fever. The Columbus Dispatch shares the account of Tobias Yoder, one of the Amish travelers:

Yoder, who is 33 and whose wife, Fannie, is now experiencing measles symptoms, said the Amish community that he grew up in is not religiously opposed to vaccines. Some do, however, opt out of shots.

He said he asked about any special vaccines that his group might need before traveling to the Philippines, but the MMR (measles, mumps and rubella) vaccine wasn’t suggested. He had no idea there was an ongoing and deadly outbreak of measles in the Philippines. Had he known, Yoder said, he would have been vaccinated.

Despite the willingness of some to be immunized, Holmes County Health Commissioner Dr. D.J.  McFadden describes his county’s vaccination rates as “dismal”.

Will this outbreak spur many of those unvaccinated to get their shots? It might be prudent, especially considering this statement by McFadden:

“The only thing about my job that keeps me up at night is the fact that I have a large unvaccinated population, and I have a large number of members of my community percentage-wise who leave the country to do mission trips overseas.”

While not commonplace, some Amish do travel internationally on mission journeys.

One reason fewer Amish vaccinate is not realizing the benefits. Hopefully this incident will encourage more vaccinations, at least among those not religiously opposed to doing so.