A measles outbreak in Ohio has sickened 85 children and hospitalized close to half of those. Doctors say none of those affected had been fully vaccinated against what they are terming “the world’s most contagious virus.”
Travel sports, including indoor tournaments in basketball and volleyball, bring children together, raising concerns among organizers. WTRF reports that the Ohio outbreak actually began in October of 2022, with the bulk of cases occurring in mid-November to early December. These community cases are thought to be linked to one of four travel-related measles cases, according to the health commissioner for Columbus.
The disease has spread mostly among school-age children whose parents declined to get them vaccinated, citing reasons such as personal freedom, philosophical or religious beliefs, or concerns the MMR vaccine could cause autism (a theory that has been debunked multiple times), authorities said.
And while the outbreak could spur some parents to action in terms of getting vaccines, the offices of many pediatricians are backed up as medical professional try to cope with an uptick of respiratory infections, including RSV.
Measles can be deadly, particularly among young children. And while the disease was initially believed to be extinct in the USA, cases have been creeping back in. According to the CDC, in 2019, 1,274 cases were reported – a figure that had skyrocketed from the year before. In 2020, only 13 cases were reported nationwide, and officials theorized that quarantine and a lack of travel were the deciding factors. But by 2021 and 2022, cases were back up, including in states where none had been reported for multiple years running. Last year, for example, Minnesota experienced 22 cases in the Twin Cities area; that was up from zero the previous year.
As far back as 2015, measles has been a running concern in the youth sports industry. Additional outbreaks, which occurred in 2018 as well as that all-time CDC high time of 2019, have occurred, causing sports event owners to weigh the possibility of vaccine requirements among youth participants.
Airports and other transportation centers, unfortunately, serve as petri dishes for infection – and cause additional headaches for planners who know kids and even adult athletes will be passing through them. Back in March of 2018, for example, it was noted that anyone who had visited airports in Memphis, Newark and Detroit could have been exposed to measles after two international travelers were confirmed to have the measles virus. A 2017 surge in measles cases included outbreaks in 15 of the 53 countries in the European Region, according to the World Health Organization (WHO). That outbreak affected 21,315 people and caused 35 deaths during 2017.
Unlike some viruses, which are more difficult to pass along, measles spreads so readily that without either full vaccination or total quarantine, there is virtually no way to guard against it.
"It is so infectious that if a person enters the room, and leaves, a couple of hours later, anyone else entering the room can get the illness, so it's difficult to prevent your child from getting measles," said Gigi Chawla, Chief of General Pediatrics at Children's Minnesota.
The Minnesota Department of Health has noted some sobering statistics. At least 95 percent of the general population needs to be vaccinated against measles in order to protect the remaining five percent because the disease is so contagious, according to Gwantwa Mwakalundwa, who teaches biology and virology at Metro State University. The number is higher than the so-called “herd immunity” rates for other diseases, she added, referring to the percentage of people that needs to be protected from a disease in order to prevent spread within a community.
“Even a small drop in the immunization coverage rate means there are thousands more children who could be vulnerable to disease because they are not vaccinated,” said Jennifer Heath, state immunizations program coordinator for MDH. “If the coverage rate in a setting like a childcare or school is significantly less than 85 or 90 percent, that’s an outbreak waiting to happen.”
“In fact,” said Mwakalundwa, who is a member of the American Association of Immunologists, “if someone is not vaccinated and they never had measles before, they have a 95 percent chance of developing the disease if they come into contact with it.”
While indoor sports pose an environment more conducive to disease transmission, some parents might consider outdoor venues less of a threat for infection than indoor venues. However, say officials, exposing potentially sick children is a risky proposition and event owners need to be aware of the ramifications.
The issue of children not being vaccinated for communicable diseases has long been a sensitive issue in the sports business world. In February of 2019, an outbreak in Washington State and Oregon made national news. Washington Governor Jay Inslee declared a state of emergency due to the outbreak three days after officials in Clark County declared a public health emergency. Before that, in August of 2018, a measles outbreak had sickened individuals in states including Arkansas, California, Connecticut, Florida, Illinois, Indiana, Kansas, Louisiana, Maryland, Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas and Washington. The majority of people who got measles were unvaccinated.
In February of 2017, an outbreak of chickenpox had caused cancellations of youth sports events in multiple states. And just as with measles, a vaccine exists for the disease. In 2014, mumps (also a disease for which there is a vaccine) hit the NHL and every year, the debate over whether to require flu vaccines fires up.
SDM’s readers weighed in on the issue in two polls in 2019, coming down on the pro-vaccine side of the line. The majority (nearly 57 percent) believed youth athletes should be required to be vaccinated in order to register for an event, while nearly 70 percent believed flu shots should be mandatory for all participants in youth sports.
What can event planners do? State-by-state regulations (and exemptions) may govern what tournament directors can specify as their vaccine requirements for participants. Those who want to examine their options should contact an attorney who can investigate and help create any applicable language. It is also helpful to have a policy regarding whether athletes can (or should) attend or participate in sports events if they are exhibiting symptoms of various diseases.
The CDC website includes consumer-friendly information on the measles vaccine. Expect tournament directors and youth sports organizations to start linking to it.