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How Communities Affected By Measles Work To Contain Outbreaks


The measles outbreak continues to spread in the U.S. The Centers for Disease Control and Prevention has reported 695 cases. That's the highest number since 2000, when measles was declared eradicated in the U.S.


There are now cases in 22 states, but the largest outbreaks have been in New York's ultra-Orthodox Jewish communities. Now a story of how measles spread from there to another community hundreds of miles away.


UNIDENTIFIED NEWS ANCHOR #1: We begin tonight with the big story connected to the crisis.

UNIDENTIFIED NEWS ANCHOR #2: For the first time, tests are confirming, the spread of measles in Metro Detroit is linked to that massive outbreak in New York

SHAPIRO: More than three dozen cases of measles in Oakland County, Mich., have been tied to one man, a man who had traveled from Israel to New York, where he was raising money for charity. He then drove to Michigan, feeling sick along the way. He went to a doctor, who thought he had bronchitis. Then he developed the telltale rash. That's when Dr. Steve McGraw got involved. He is medical director for Oakland County's emergency medical services, and he also works with Hatzalah, an all-volunteer emergency response group. Dr. McGraw, welcome to ALL THINGS CONSIDERED.

STEVE MCGRAW: Thank you for having me.

SHAPIRO: Now, I understand you first got word from county health officials that a man in the area was suspected to have measles and then you, along with a local rabbi, went out to find him. What happened?

MCGRAW: He and I were both looking for the gentleman who was not trying to elude anyone, he just didn't know he was sick and contagious. But based on the knowledge that the rabbi had of where he had been and where he was likely to go, the two of us were able to sort of triangulate and figure out where in the community he could be found.

SHAPIRO: What was his reaction when you told him that you believed he had measles?

MCGRAW: Well, at first, I think he was very upset and, frankly, devastated that he had realized at that point he had been inadvertently exposing people to his disease that he didn't even know he had. But he immediately changed gears and wanted to help in any way he could. Specifically, he told us in very detailed terms where he had been, whom he had visited. And then most importantly, he was able to give us sort of a chronologic period about when he became sick and when he became contagious.

SHAPIRO: Knowing that this virus can be contagious for days even before the rash appears, what did you know you had to do once he laid out for you where he'd been?

MCGRAW: Well, the public health officials in Oakland County put out a public alert on all the normal media. But for those that don't maybe have access to the same type of media, in the Orthodox community, there's a device called a calling post where the rabbis permitted me to script and describe what should be done for people that may have been exposed, where they could go to get vaccinated if they weren't certain they were immune. And then that word gets spread out to the cellphones in the community, sort of like one big voicemail to everyone.

SHAPIRO: One of the things that I find so interesting about this story is that the thing that makes measles spread easily within this community, which is its insularity, also allows the community to quickly mobilize to address the problem.

MCGRAW: And they responded extraordinarily well. Their rabbinical leadership and those in the community themselves took every advantage of going to both the traditional county health clinics, as well as participating with pop-up clinics that the county was kind enough to establish in their own synagogue.

SHAPIRO: I also want to ask you about this volunteer organization, Hatzalah, which serves the Jewish community. You yourself are Irish Catholic, but that was your connection to this group. Tell us about the role that it played.

MCGRAW: The men and women of Hatzalah are not only volunteers, but they're also community members as well - highly regarded residents of the community. And they collaborate and work very well with the local rabbinical people, as well as those in public health, especially when it came to setting up things like the calling post or the immunization clinics in a synagogue. Members of Hatzalah were able to help people at the door, fill out paperwork. It gave them a welcoming face in an environment that they felt safe anyway to go and receive the vaccines.

SHAPIRO: And so now that the country is seeing numbers of measles cases they haven't seen in years, what is the situation where you are in Michigan?

MCGRAW: Well, if the most recent two weeks has been any indication, I think we've seen the worst of it. We had our initial case. We had the secondary cases from him and then a few household cases connected to those secondary cases. And that's really been it. It really depends not only on making sure that you get vaccinated if you're not certain to be immune, but for those unfortunate that do contract the disease, they follow the recommendations of the county to the letter. And it's a tremendous credit to those folks, who, despite having been feeling so ill themselves, protected the community at large by staying where they were and doing as they were instructed.

SHAPIRO: I'm struck by the fact that the majority of recent measles cases in the U.S. have been within insular communities, whether that's ultra-Orthodox or Amish or Somali immigrant groups. What lessons do you think public health officials can learn from that?

MCGRAW: I hope others will see that by reaching out to these communities and doing so in a way that's affected with kindness and with knowledge, you can bridge whatever cultural difference there may pre-exist and to make sure everyone understands we're all in this together. We're working together to try to stop a problem, that untreated an undefended, could lead to something much worse.

SHAPIRO: Dr. Steve McGraw, thanks so much for talking with us.

MCGRAW: Well, thank you for your time, Ari.

SHAPIRO: He's the Oakland County, Mich., EMS medical director. Transcript provided by NPR, Copyright NPR.