State health officials got the troubling news last Thursday: A Minneapolis child care center was not cooperating with efforts to stop the spread of measles, and the problem was getting worse.
For nearly four weeks, the Minnesota Department of Health had been battling a measles outbreak that is now the state's worst since 1990. The Minneapolis day care center was one of 11 where infected children have exposed thousands of others — many unvaccinated — leading to an outbreak that has sickened 54 people and spread to rural parts of the state. And now the center was refusing to cooperate with Health Department instructions.
"We could continue to see new cases from this," said Jennifer Heath, who leads the department's efforts with child care centers and schools.
After a brief discussion, Heath and the group decided to contact the state Department of Human Services, which oversees child care providers, and ask for enforcement help.
It was just one item of business on a busy morning for the Health Department's measles incident command team, which has been convening daily since shortly after the outbreak began to monitor new cases, review infection control efforts and coordinate with local public health officials.
Incident command, which includes about two dozen leaders from various corners of the Health Department, oversees a vast network of efforts across the Twin Cities and the state. So far, it has identified more than 7,000 people exposed to the virus at the child care centers, three schools and about 20 health care settings. Nearly 500 people have been asked to limit public contact because they lack immunity protection.
A major part of the control effort is finding people who have been exposed to known cases, especially people who don't have immunity. By intervening with them early, public health officials can potentially prevent them from getting sick and infecting others.
"You want to get ahead of the outbreak and catch cases early," said Melissa McMahon, one of the department epidemiologists tapped to help.