Thursday, June 14, 2001

25 Kauai students
isolated for measles

They were exposed to it
during school by a
16-year-old classmate

By Helen Altonn

About 25 Kauai youths have been quarantined at home because of exposure to a 16-year-old classmate diagnosed with measles.

Since school is out, they want to go to the beach, said Jo Manea, state Department of Health epidemiology specialist.

But, she said, "My evidence that they are complying with the restrictions is that a lot of kids answered the phone when I called."

Manea said no new cases have been identified since the 16-year-old boy was hospitalized last Thursday, causing the Health Department to launch a measles alert and hold a free clinic for measles shots.

However, students who were in school with the boy must remain confined until the 21-day incubation period ends next week, she said.

About 25 students either had no measles immunization history or had only one of two shots required for measles, mumps and rubella, known as MMR, she said.

She declined to identify the school but said it is small, "so just being in the same school was enough in this situation to say it was exposure."

The 16-year-old is home, and his mother said he is feeling much better, Manea said.

It is believed the boy became infected on a family trip to Europe.

The parents either were immunized for measles or had the illness when young, so they were protected.

Manea said 10 shots were given at the school to susceptible children, the sibling of a student who was susceptible and one staff person.

About 15 shots were given in a free clinic Friday at the Kilauea Neighborhood Center, she said.

"The good thing about that clinic, most people we gave MMR vaccine to were people who were susceptible," she said, including some adolescent girls and young women who had never been immunized.

A few more students from the school showed up who had never had MMR vaccine or had only one shot.

"So it was worthwhile because the people we immunized were high risk," Manea said.

The second shot must be given four weeks after the first, she said. Those getting vaccinated were told to get the second shot from a private physician or attend public-health nursing clinics held once a month in various communities around the island, she said.

It takes seven to 21 days after exposure for symptoms to develop in an infected person, she said.

She said parents have called her to ask if it was all right for kids being quarantined to hang out together until the incubation period is over.

"I had to say no. Quarantine means stay home. Don't go out of your house to go to a friend's house. ... It's old-fashioned quarantine."

One child might be exposed to another who may turn out to be infected, she pointed out.

It will be extremely unusual if no one else comes down with measles after four days' exposure in a school setting with children who were never immunized, she said.

According to medical literature, 30 percent of susceptible people in institutional settings and 100 percent of people in households become infected after exposure to measles, she said.

Manea said she called parents Tuesday, and many of the kids answered the phone. She said the parents and children listened to all the information about measles, a highly contagious illness.

She said she is concerned by conversations with some people who prefer not to immunize.

"I get the feeling from them that measles is no big deal, that it's one of those childhood diseases everybody got in the old days," Manea said. "It's been difficult for me to get the message across that measles is ... a serious illness and people die from it.

"The reason we don't see too many people dying from it is, we don't see too many people with measles."

Someone with a temperature of 103 or 104 degrees for a week and must stay in bed can get pneumonia, ear infections and other complications, she pointed out.

"Why subject your child or family member to that rather than a safe and effective immunization?" she said.

Although immunizations are required to enter school, religious exemptions can be requested, Manea said.

"Somehow, the community that doesn't want to immunize perceives it as not safe and not effective, but the evidence is very clear. There are multitudes and multitudes of studies on thousands and thousands of people.

"The choice is, get the disease and all the side effects, or take immunization."

People who oppose immunization say they will keep their children home if they are infected, but the 16-year-old had not stayed home, Manea said.

He went to school even though he did not feel well because it was the week before finals with a lot of tests, and he did not know what his illness was.

"He felt responsible for completing the school year," she said.

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