Measles Outbreak Continues to Spread in Minnesota: 75 Cases Now Confirmed

A girl receives anti-measles vaccination drops at a health centre in BASECO compound in Tondo, Manila September 3, 2014. Philippine President Benigno Aquino said on September 1, 2014 between 11 to 13 million people in the country are at risk from measles, polio and rubella (German measles), and asked the …
Erik de Castro/Reuters

The recent measles outbreak continues to spread in Minnesota. On Monday, the Minnesota Department of Health reported a total of 75 confirmed cases, five more than were confirmed in the entire country in all of 2016.

The rate at which the disease is spreading has slowed over the past two weeks, increasing by six new cases from the 69 confirmed on May 22. It has also been confined to four counties during that period of time: Hennepin County and Ramsey County in the Minneapolis-St. Paul area, Crow Wing County in the north part of the state, and Le Sueur County in the southeast part of the state.

“There are now more measles cases in Minnesota than there were in the entire United States last year,” CNN reported on Friday.

According to the Centers for Disease Control, 70 cases of measles were confirmed in the United States in 2016, down from 188 in 2015 and 677 in 2014.

To date, 63 cases have been diagnosed among Somali Minnesotans, nine among White/Non-Hispanics, and three among White/Hispanics, according to the Minnesota Department of Health (MDH) website.

Minneapolis-St. Paul is home to the largest Somali community in the country, estimated to be about 70,000 in total. More than 100,000 Somali refugees have been resettled in Minnesota by the federal government since 2002, according to the State Department interactive website.

The MDH provided this additional information about the  2017 measles outbreak in Minnesota on Monday:

75 total cases:
66 in Hennepin County
3 in Ramsey County
4 in Crow Wing County
2 in Le Sueur County

Vaccination status:
69 confirmed to be unvaccinated
3 had 1 dose of MMR
3 had 2 doses of MMR

72 in children (ages 0-17 years)
3 cases in adults

The first case of measles during this outbreak in Minnesota was reported to the public on April 13.

The first 20 cases were diagnosed within the state’s large Somali community.

“This outbreak has nothing to do with being Somali, but it has everything to do with being unvaccinated,” Kristen Ehresmann, director of the Infectious Disease Epidemiology, Prevention, and Control Division at the state Department of Health, told CNN on Friday.

“About a decade ago, parents in the community started to notice what appeared to be a disproportionate number of Somali children receiving special education services for autism in Hennepin County, home to Minneapolis,” CNN reported :

While trying to make sense of the autism rates, the parents discovered the work of discredited British researcher Andrew Wakefield, who first suggested a link between vaccines and autism in a study later found to be fraudulent. Then, local anti-vaccination activists started to hold meetings in Minnesota’s Somali community.

“So as the health department and others were reaching out to the Somali community with information about resources for autism … the anti-vaccine groups were reaching out to them to provide misinformation,” Ehresmann said.

Within a few years, MMR vaccination rates plummeted among Somali-American children in Minnesota.

“We’ve seen a precipitous decline in MMR coverage levels within this community,” Ehresmann told CNN. “Going from actually rates that were higher than the rest of Minnesota, prior to 2007 to 2008, to rates that are currently at 42%.”

“Minnesota’s health department is preparing to help prevent any additional transmissions of the measles virus within the Somali community during Ramadan, a holy month of fasting and prayer for Muslims, Ehresmann said. Many in the Somali-American community are observing Ramadan, which began May 26,” CNN reported:

“At the end of Ramadan, the big celebratory feast is something that’s attended by everyone, and many mosques will join together for that. So you not only have everyone in attendance, but you also have potential for even greater mixing than usual,” Ehresmann said.

The health department has collaborated with imams, the prayer leaders of mosques, to encourage those who might be sick with measles to avoid gathering with others, as it could spread the disease, she said.
“The imams have let us know that one of the values or messages in Islam is, if someone is ill, that taking time to be alone or to isolate oneself has a spiritual benefit,” Ehresmann said.

“That actually would be consistent with some of the messages that we would have about making sure that ill individuals are excluded from social congregate settings.”

Measles is not the only health problem within Minnesota’s Somali community.

Ninety percent of the 168 cases of active tuberculosis diagnosed in Minnesota in 2016, or “(152 of 168) were foreign-born, significantly higher than the national 2016 average of 67.9 percent of active TB cases that were foreign-born,” Breitbart News reported:

Fourteen of these 168 cases, or 9 percent were diagnosed within the first year in the United States of the  2,635 refugees who were resettled in Minnesota in FY 2016. The majority of these refugees came from two high TB burden countries: 1,195 came from Somalia, and 653 came from Burma, according to the State Department’s interactive website. . .

“During the five years between 2010 and 2014, 732 cases of active TB were diagnosed in Minnesota. Of these, 81 percent, or 593, were foreign-born. Of foreign-born cases, 50 percent, or 296, were refugees, according to ‘The Epidemiology of Tuberculosis in Minnesota, 2010-2014,’ a report published by the Minnesota Department of Health,” Breitbart News reported previously.

“Twenty-nine percent of the 593 foreign-born cases of active TB diagnosed in Minnesota, or 161, were attributed to Somali born migrants. Almost all Somali migrants to the United States have arrived under the federal refugee resettlement program,” Breitbart News noted.

In May, Minnesota Health Commissioner Dr. Ed Ehlinger asked for an extra $5 million in state funding to address immediate public health concerns in the state. Ehlinger said:

In recent months, state and local public health officials have had to respond to a series of infectious disease outbreaks including multi-drug resistant tuberculosis, hundreds of new cases of syphilis, and now, the largest measles outbreak the state has faced in nearly 30 years. These outbreaks come on the heels of extensive public health efforts in 2016 for the Zika virus response and in 2014-15 for Ebola preparedness.

With state and local response costs for the first half of 2017 approaching $3 million just for measles, tuberculosis and syphilis, I respectfully request that the legislature create a public health response contingency fund of $5 million to ensure sufficient resources are available for immediate, life-saving actions to protect Minnesotans from infectious disease outbreaks and other unanticipated public health threats.

“Governor Dayton has given me his support for this proposal and we will advocate for its inclusion in any final legislative budget agreement,” Ehlinger noted.


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