Containing a Measles Outbreak in Minnesota

CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement program is a critical source of funding, guidance, and technical assistance for state, local, tribal, and territorial public health departments to strengthen their public health preparedness capabilities. Since 9/11, the PHEP program has saved lives by building and maintaining a nationwide public health emergency management system that enables communities to rapidly respond to public health threats.

Measles is a vaccine-preventable virus and was once virtually eliminated in the United States, though it is highly contagious and can still spread rapidly among unvaccinated populations. Such was the case in April 2017 when a measles outbreak in Minneapolis and surrounding Hennepin County had, by late June, accounted for approximately 70 cases. Were it not for an effective state and local public health response, that number could have easily been in the hundreds. Relying on PHEP-funded infrastructure and lessons learned from other recent emergencies, Hennepin County Public Health instituted an emergency management structure capable of leading the public health response, and maintained an epidemiologic surveillance system capable of faster detection and identification of measles cases.

The health department activated two interlinked department operations centers — a primary site in suburban Hennepin County and a secondary one in downtown Minneapolis — to coordinate the response. Epidemiologists, partially funded by PHEP, investigated potential cases and worked to determine the severity of the cases, potential contacts, and vaccination needs. If a suspected case could not be reached by phone, the health department developed a plan which sent a PHEP-funded team consisting of a public health nurse and a cultural liaison to conduct a home visit. Because the local Somali community was particularly affected by the outbreak, the cultural liaison was very effective in building trust with Somali families and contacts and communicating the importance of vaccination. Emergency preparedness planners and operations staff also developed plans to set up mobile vaccine and treatment clinics, if necessary.

After a child in a local school became infected, potentially exposing many other children, the health department set up a clinic to provide measles antibody injections to prevent illness. Health department staff worked with their cultural liaisons to determine the best time for the community to attend, maximizing participation. The health department used its dispensing training to set up the clinic in less than 24 hours and keep the antibody medications at the required cold temperature the entire time. Two Medical Reserve Corps volunteer nurses participated in the clinic.

The health department worked with the local media to ensure factual and timely measles information reached the public. The resulting community dialogue helped dispel vaccine myths and supported a significant increase in vaccinations, further curtailing the outbreak.

MMWR 2017 Measles cases, by week.

Figure: Measles cases by week, data from VPD Surveillance unit.

Measles is a highly contagious, vaccine-preventable virus that causes high fever and rash and can lead to further complications such as ear infections, pneumonia, and swelling of the brain.

Measles is a highly contagious, vaccine-preventable virus that causes high fever and rash and can lead to further complications such as ear infections, pneumonia, and swelling of the brain.

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The Incident

A 2017 measles outbreak infected 70 people in and around Minneapolis.

The Response

Epidemiologists and home visitors investigated new cases and counseled potential cases throughout the course of the event. The health department also set up a clinic after a local school was exposed.

The Outcomes

The measles outbreak was curtailed, vaccination rates increased, and there was positive community dialogue about the importance of vaccination.