During 1990, nearly 5,000 measles cases and 21 deaths were reported in Los Angeles County, California with the Latino population, 35 percent of the county’s total residents, hit especially hard, comprising 65 percent of the cases.
The disproportionate rate of infection among Los Angeles Hispanics was blamed on several factors including Reagan era cutbacks on federal public health funds and among many English limited residents, a lack of knowledge about the disease itself and what has been described as an “exquisitely contagious” virus.
“Some Hispanics think that it’s OK for everyone to get measles in childhood. Others simply don’t understand how serious the disease is,” Dr. Shirley Fannin, director of Los Angeles County’s disease control programs, told the Los Angeles Times newspaper in May 1990.
A lot has changed in the public health sector in the intervening years. By 2000 measles was considered eliminated in the United States due to widespread childhood vaccinations and rules such as the one in Connecticut where children are not allowed to enter school without proof of immunization or a physician’s or religious exemption.
Still, this infectious disease has made a highly publicized comeback, in two dozen states including Connecticut. As of mid-May, the number of cases nationally topped 880, according to the Centers for Disease Control and Prevention, or the highest total since 1994.
In Connecticut, the state Department of Health has reported three cases, all involving adults from New Haven County. This is the highest total since 2014 when five cases were reported and far short of 1973 when 1,789 cases were reported in the state.
What does the latest surge of measles mean to Connecticut’s large Hispanic/Latino population? First of all the conditions that existed in 1973 and 1990 are dramatically different from those today. Generally use of the MMR vaccine in childhood, which protects against measles, mumps, and rubella viruses have greatly reduced the risk of a widespread epidemic, although anti-vaxxers have cut back on inoculations in some communities.
Moreover, the two major hot spots of the ongoing measles breakout are large ultra-conservative Jewish communities in Brooklyn and Rockland Counties, New York, and relate to religious attitudes that vaccinations represent the secular world trying to weaken the Hasidic Jews social fabric.
In regard to the growing immigrant population, many of the newcomers come from Latin America come from countries where there are high rates of measles vaccination among children 12-23 months. Data from the World Health Organization (WHO) that show the measles vaccination rate in Mexico is 99 percent — much better than the U.S. rate of 92 percent — although some conservatives have questioned the accuracy of these numbers.
But still, Latinos, especially undocumented immigrants, even those vaccinated, need to be aware that there are what Connecticut’s new commissioner of the Department of Public Health calls “some pockets of vulnerability.”
Some of these areas of possible exposure include school districts with low vaccination rates, jobs such as airports and international travel. Five years ago, there was a measles outbreak in California, about 100 people, with more than half of the cases having some connection to either attendance of employment at Disney parks.
For example, the infected Hasidic communities often rely on undocumented immigrants, who mostly come from Central American countries with vaccination rates comparable or slightly less than New York State. However, these people may carry the virus home to unvaccinated young children and the elderly, according to a report in the Jewish media mainstay Forward by Ari Feldman.
One of Connecticut’s current measles cases was traced to infection during a visit to Brooklyn, New York.
Another issue that was a major concern in Los Angeles County in 1990, still hangs over Hispanic communities including those in Connecticut. Many of the sick were undocumented immigrants who feared deportation if they used government-sponsored clinics to obtain vaccinations.
This wariness is something that Malta House of Care, a church-related Hartford-based free medical program for adults without health coverage, occasionally encounters today. A majority of the mobile clinic’s patients are Hispanic who sometimes need to establish a trust level with the volunteer program, especially undocumented immigrants, explained the volunteer program’s spokesperson.
Malta House of Care’s mobile clinic provides vaccinations for the flu and does provide measles immunizations, do but does not serve children.
Connecticut has been focusing on school-based prevention efforts, making sure the requirement of proof of measles vaccination before admission to kindergarten is being followed and has spawned a dialogue over the use of religious and physician-authorized exemptions. In this regard, public health officials and state legislators are looking for ways to compel vaccinations are being considered.
A vaccination rate above the 95 percent federal guideline is considered sufficient to prevent a large-scale outbreak, and in Connecticut, 96.5 percent of the state’s kindergarten population have received their measles, mumps and rubella vaccinations (MMR), according to information released May 3 and then updated May 10 by the state Department of Public Health.
The overall kindergarten rate, however, was down 0.6 percent since 2012-13 while the use of religious exemptions by parents and guardians was up by the same percentage.
However, there are at least 100 schools where the kindergarten vaccination rate falls below the CDC standard and some of the schools with the lowest vaccination rates are in cities with large Hispanic populations including Bridgeport, Hartford, and Stamford.
According to the state, the Six-Six Magnet School in Bridgeport’s northwest section has a vaccination rate of 85 percent with 15 percent of the students under religious exemptions.
The incidence of measles among Hispanics has not been watched as closely as that population’s experience with cardio-muscular and chronic liver diseases as well as diabetes. A spokesman for the Centers for Disease Control and Prevention stated recently “we do not have a breakdown on currently reported measles cases by age and racial/ethnic subset.
California, which has the nation’s largest Hispanic population, more than 14 million people and 2.2 million of the nation’s 10 million unauthorized immigrants. also reported it was not tracking the ethnic background of those infected with measles.
In Connecticut, where the population includes approximately 120,000 undocumented immigrants, attempts to obtain Latino-relation information from the Connecticut Department of Public Health had been unfruitful as of deadline.
The good news for Latinos is that race or ethnicity per se is not a risk factor for measles, but everyone is at high risk of catching the disease if they have not been immunized and are then exposed to the virus while traveling abroad or back at home, states the California Department of Public Health.