May 2018 Epi Bulletin

Measles Prevention

Measles virus is highly contagious and spreads through the air through coughing and sneezing of an infectious person. Measles symptoms typically begin with high fever, cough, runny nose and red, watery eyes. This is follow by a rash that appears 7-21 days after the day of exposure.

Measles cannot be spread to others by people who do not have the disease. Four days before the onset of rash and four days after the onset of rash is the time that someone that has measles could most likely infect other people. Unfortunately, most people do not know they have measles before the rash.

Measles can lead to serious complications in very young children, pregnant women and people with a weak immune system. The best protection against measles is vaccination followed by preventing exposures to other people. Measles vaccine is not routinely given to children less than one year old. Children older than 6 months of age may be started on the vaccination following an exposure, but not children that are younger than 6 months.
Measles vaccine is very effective in preventing measles. According to the CDC, receiving one dose of the MMR vaccine is 93% effective at preventing measles and if you have received your MMR booster (second dose), the effectiveness increases to 97%.
People that are unvaccinated for measles and have never had the disease are most likely to contract the virus when exposed. Receiving one dose of the vaccine does not provide the highest level of immunity that the vaccination can offer.
Important steps in containing the spread of the disease and controlling an outbreak are:

  • Vaccinating everyone that could receive the vaccine
  • Providing booster doses to complete the two recommended doses when possible
  • Isolating sick individuals and
  • Excluding people who are not vaccinated or fully vaccinated after an exposure 

Unvaccinated children or children not fully vaccinated could be excluded for 21 days or more following exposure. This means that in a situation were multiple cases were identified over time in a school, exclusion period for such children could be longer than even the 21-day minimum.

Keep children at home away from other people, from school and from public places if you suspect measles. Adults should do the same. Also, call your healthcare provider, the clinic or the hospital, and inform them about possible measles before heading out to seek treatment. This will allow them to plan for your arrival and to limit exposures to other people.

For more information about measles, click here. Clay County Public Health Center can be reached at 816-595-4364.

Please help us in controlling the current outbreak of measles in the Kansas City metro area.


Healthy Weight in Pregnancy

A woman’s weight before and during pregnancy is important for her health and the health of her baby. Studies have shown that children born to mothers who were normal weight are more likely to have better outcomes. Women who are overweight or obese during pregnancy are more likely to experience certain conditions during their pregnancy. These include:

Gestational diabetes: diabetes that is first diagnosed during pregnancy. This condition can increase the risk of having a cesarean delivery. Women who have had gestational diabetes also have a higher risk of having diabetes in the future, as do their children. Pregnant women are screened for gestational diabetes early in pregnancy and may be screened later in pregnancy as well.

Preeclampsia: high blood pressure disorder that can occur during pregnancy or after pregnancy. It is a serious illness that affects a woman’s entire body. Preeclampsia can lead to seizures, a condition called eclampsia. In rare cases, stroke can occur. Severe cases need emergency treatment to avoid these complications.
Sleep apnea: a condition in which a person stops breathing for short periods during sleep. Sleep apnea is associated with obesity. During pregnancy, sleep apnea not only can cause fatigue but also increases the risk of high blood pressure, preeclampsia, eclampsia, and heart and lung disorders.
Being obese during pregnancy also put babies at risk of some health issues such as:
Miscarriages—Obese women have an increased risk of pregnancy loss (miscarriage) compared with women of normal weight.
Birth defects—Babies born to obese women have an increased risk of having birth defects, such as heart defects and neural tube defects.
Problems with diagnostic tests—Having too much body fat can make it difficult to see certain problems with the baby’s anatomy on an ultrasound exam. Checking the baby’s heart rate during labor also may be more difficult if you are obese.
Macrosomia—In this condition, the baby is larger than normal. This can increase the risk of the baby being injured during birth.
Preterm birth—Problems associated with a woman’s obesity, such as preeclampsia, may lead to a medically indicated preterm birth.

Stillbirth—The higher the woman’s BMI, the greater the risk of stillbirth.
Before planning your pregnancy, talk with your healthcare provider to plan and to create a healthy pregnancy weight goal. For more information, click here.

The Women, Infants and Children's Program (WIC) is available to provide nutritional support and is effective in helping improve the health of pregnant women, new mothers, and their infants. Studies have showed that qualified women who participated in the program during their pregnancies had lower Medicaid costs for themselves and their babies than those who did not participate. WIC participation was also linked with longer gestation periods, healthy birthweights and lower infant mortality. For more information on WIC, click here .

For information on the Clay County Public Health Center's Program that supports WIC, click here.


Raw-Unprocessed Milk and Public Health

As processed foods become more common in the United States, many Americans seek to “get back to nature” and minimize their consumption of processed foods. While eating a less processed food and fresher diet can be a healthier option, certain unprocessed foods can pose serious health consequences.

Raw milk is one of these less processed foods that can have grave consequences. Raw milk has not undergone a process called pasteurization, which kills harmful germs from the cow that can make people sick. Some of these illnesses include Campylobacter, E. Coli, Salmonella, and Listeria. Symptoms of these illnesses can include diarrhea, vomiting, and stomach pain or cramping. Some people can develop severe or life-threatening conditions, such as kidney failure, paralysis, or stroke.

Every year, several outbreaks relating to raw milk consumption are reported across the United States, including Missouri. According to the CDC, from 1993-2012, 127 outbreaks with over 1,900 illnesses have been reported. The number of outbreaks linked to raw milk has been increasing in the last five years and the risk of an outbreak caused by raw milk is at least 150 times higher than the risk from pasteurized milk. In addition, children were at the highest risk for illness from raw milk.

In many states, it is illegal to sell raw milk and, in these states, there are fewer outbreaks due to raw milk. In Missouri, sales of raw milk are legal. However, these sales are not well-regulated. While in some cases, eating less processed foods can provide health benefits, raw milk is one case where getting back to nature is not the healthiest option.

Clay County Communicable Disease Data Summary

The 2018 year-to-date disease report for MMWR Week 16 shows that most reportable disease conditions remained within what is expected for the county. Clay County has not had any confirmed cases of measles in county residents. However, we continue to receive reports of measles exposures in the county due to confirmed cases in other jurisdictions.

The Clay County Public Health Center recommends that providers consider measles in any patient with a rash illness especially those who also have a cough, runny nose, red watery eyes, and fever. We continue to recommend both IgM and PCR measles testing for such patients. Please report all suspect and confirmed cases to your local health department.

Milder symptoms have been reported in recent adult cases. Providers need to be aware of this to avoid misdiagnosis among adults. 


April 2018 Communicable Disease Data

To view the chart of communicable disease data, click here.

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