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Measles Epidemic Worsens in Orange, Other Counties

TIMES MEDICAL WRITER

The measles epidemic that has plagued Southern California since late 1987 has dramatically worsened, with Los Angeles County and the Inland Empire, the hardest-hit areas, reporting many more cases during the first three months of 1990 than in all of 1989.

Dramatic increases in rubeola cases have also been registered throughout the Central Valley and in San Diego County, and a measles outbreak has developed in Alameda County.

In Orange County, officials have documented 110 cases through March, but another 94 cases are suspected of being measles. If those check out, that would bring this year’s rate well above the 120 cases the county recorded in the first four months of 1989.

“Children are getting ill, going to the hospital and dying,” said Dr. Loring Dales, chief of the immunization unit for the state Department of Health Services in Berkeley. “We are really stunned by not only the amount of illness but also the severity. . . . (It is) the kind of thing you would see in Calcutta.”

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Most of the current cases are occurring in preschool-age children who have never been immunized against measles. Previous epidemics have largely affected school-age children or young adults.

In Orange County, Latino youngsters, particularly preschoolers, are the hardest hit, county epidemiologist Thomas J. Prendergast said. In February, for instance, 15 of 33 measles cases involved children less than 12 months old, and 28 of those affected were Latinos.

The disease travels quickly among Latinos because many of these people travel to Mexico, where measles is also raging, then return to Orange County with the disease, Prendergast said.

Statewide, a quarter to a third of measles victims have needed hospitalization, primarily for pneumonia or dehydration. About one in 200 of the afflicted individuals have died; the U.S. pattern is usually one death for every 1,000 to 3,000 measles cases.

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“We feel like we’re under siege,” said Dr. Gary Euler, chief of immunization programs in San Bernardino County, where health officials have documented 910 cases and five deaths already this year; they had 650 cases and five deaths during all of 1989. San Bernardino officials said the county’s rate of new cases is the highest in the state, possibly in the nation.

As of Thursday, 1,407 measles cases and six measles deaths had been reported to Los Angeles County health officials. There were 1,202 cases and 17 deaths last year. The incomplete March case total of 661 is already the highest monthly total in 13 years.

Besides Latinos, particularly hard hit are Asian and Pacific Islander minorities and children of all racial and ethnic groups in low-income communities. Victims who go to hospitals are unwittingly helping to spread the disease, especially in emergency rooms where sick people often face long waits.

Orange County is aggressively immunizing all members of a family when one contracts the disease, Prendergast said. Also, its regular immunization clinics are actively subscribed.

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The large county clinic on 17th Street in Santa Ana now immunizes 6,000 people a month, up from 3,000 a month at this time last year, said Dr. Gerald A. Wagner, medical director of the county’s immunization program.

Hospitals in Orange and San Diego counties are warning potentially infected individuals not to mingle with others seeking treatment and are advising parents to leave their other children at home.

A first measles vaccine is recommended for children at 12 months and a second dose at 4 to 6 years. But the vaccine is not foolproof; 5% to 10% of recipients fail to achieve immunity after one dose of the vaccine.

Times staff writers Lanie Jones in Orange County, Jenifer Warren in Riverside, Jerry Gillam in Sacramento, Greg Johnson in San Diego and Joanna Miller in Ventura contributed to this story.

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MEASLES IN CALIFORNIA The persistent measles epidemic is dramatically worse, with more cases of the highly contagious viral infection reported in Fresno, Los Angeles, Riverside, San Bernardino and San Diego counties during the first three months of 1990 than in all of 1989. If trends continue, the measles epidemic may surpass the 1977 epidemic, when 9,000 cases were reported statewide.

1989 JANUARY-MARCH 1990 CASES DEATHS CASES DEATHS California 3,048 25 N/A *24 Los Angeles County 1,202 17 1,411 6 San Bernardino County 650 5 910 5 Orange County 388 0 *204 2 Fresno County 327 1 332 8 San Diego County 191 0 *467 0 Riverside County 166 2 512 2 Ventura County 8 0 2 0

* Includes cases under investigation. SOURCES: County health departments, state Department of Health Services.


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