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Monday, May 22, 2017

Measles outbreak in Minnesota


There is a measles outbreak in Minneapolis, Minnesota. There are now 66 cases.  The vast majority have been in the local Somali community.  Vaccination rates in 2-3 year olds has fallen to 41% in recent years.

About 8 years local Somalis started to notice increasing numbers of their children were in special needs classes in school, many diagnosed with autism.  It caused alarm in the community.   Those who oppose vaccinations starting giving talks in the community proposing a connection between the MMR vaccine and the rates of autism.  Mother's stopped having their children vaccinated or they were waiting later to vaccinate to see if their child would develop normally.

Immigrant communities are often isolated due to language barriers. It is natural to live in communities together when you share a culture and language and are in a new, often scary  place.  In Minneapolis, many  Somalis live in a few high density high rises. It is a nightmare scenario for an epidemic: people living in very close proximity to each other sharing elevators, laundry rooms, children playing with each other. Everyone shops at nearby stores, goes to cafes in the neighborhood. People who can't speak English get their news from within the community. Word travels fast among mothers when children are being adversely affected.

Add to this the fact that Minnesota requires vaccinations for school age children, but parents are allowed to "opt out" if they have philosophical objections. All  of these elements have led to the current outbreak. Health officials are scrambling to get it under control.

What is the answer to preventing this in the future? It's a tough one.  Education first and foremost. Factual information for the community.  There has been no decrease in autism since vaccination rates have decreased. The rate of autism for the Somali population is not higher than that of the rest of the community.  Measles can kill.  Perhaps take away the opt out of vaccination rule. No vaccination, no school. Your child will have to be home schooled.

Most of all, the health departments need to hire members of the local community to educate immigrant populations about health care.  They need someone who looks like them, knows their community, someone they can trust, to advocate and educate them.

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