Though measles has not yet made its way to Island County this year, officials are concerned about the disease’s recent resurgence.

During the Island County Board of Health meeting last week, Dr. Howard Leibrand, the county’s public health officer, gave a brief update on the nation’s measles outbreaks and the importance of vaccinations.

“It’s a victory we won, and it’s something we’re now losing,” he said, “and it would be nice to reverse that.”

Leibrand went on to explain that there are two measles diseases — rubeola, which is the one being talked about now, and rubella, which is also known as German measles. It was a minor disease, he said, but not a minor problem because some infants and immunosuppressed people got pneumonia or encephalitis. Back in the 1940s, 1950s and 1960s, there were about 250 hospitalizations out of 1,000 cases and one to two deaths per 1,000 people who got it.

Anybody born after 1957 needs to either have gotten the vaccine or the disease itself to be protected from measles. People who received vaccines between 1968 and 1989 need to be revaccinated with a stronger dose.

Before 1963, Leibrand recalled, there were millions of measles cases and hundreds of deaths in the U.S. In the last 10 to 15 years, cases are numbering in the hundreds and between five and 10 deaths each year. This year alone, there have been 351 cases in 15 states, including Washington. As of March 17, two cases have been identified in the state.

Leibrand said there are several reasons for the upsurge. Although the U.S. may have eradicated the disease, the rest of the world has not, and it’s been spreading by international travel. All of the cases in the last decade were “imported” from outside the nation and then spread within the states.

Measles is very contagious with a high transmission rate; Leibrand said nine out of 10 unimmunized people will get it after contact with someone who has it. Measles also has a long incubation rate, seven to 21 days. This means people can spread it before feeling sick, which Leibrand compared to the COVID-19 virus.

The immunization rate for herd immunity must be around 95% to prevent measles from spreading. Leibrand said some states average over 90% while others are as low as 80%.

“But the problem is there’s pockets of unimmunized people related to their beliefs, related to rural communities where they don’t have very good access,” Leibrand said.

The measles, mumps and rubella (MMR) vaccine, which is administered in two doses, is 97% effective.

Leibrand said measles is a great example of why funding for the United States Agency for International Development, or USAID, is so critical. The Trump Administration has proposed major cuts to the program that helps support vaccines for residents of other countries where outbreaks of measles are more common. If that USAID funding goes away, Leibrand said, then the amount of unimmunized people and outbreaks in the world will go up, which directly affects the U.S. when the disease is brought back from outside the country.

“If you have leaders who are not in themselves great supporters of vaccine, just a little bit of a shift in these numbers will make a huge difference,” Leibrand said. “And I think we’re seeing that happen. COVID made everybody trust vaccines less, for the most part.”

That same vaccine hesitancy, he added, has transferred to other types of inoculations.

Commissioner Melanie Bacon, who contracted measles as a young girl, will not soon forget the disease’s symptoms.

“I vividly remember the itching, the agony, the temperatures, the delirium at night, where I saw dragons on the ceiling,” she said. “I don’t know if I’ve ever as a person been that miserable for such a long time and been aware of it in that way.”

The idea that there are well-meaning parents out there who would intentionally put their children in a situation where they might have to go through that misery, she added, is horrific. She asked about obligatory vaccines for school children.

Leibrand responded that vaccines are required but exemptions can be obtained for medical or religious reasons. If there was an outbreak, the county health department could ask unvaccinated people to stay home from school.

“I don’t know how that would go over politically at this point, but it certainly would be the proper response from a medical standpoint,” he said, adding that the requirements are a lot softer than they used to be.

Public Health Director Shawn Morris pointed out that Washington has a long history of being a vaccine choice state, although personal or philosophical exemptions for vaccines are no longer being accepted.