Major Measles Outbreak at Detention Center in Arizona
by Christopher Zoukis
An infectious outbreak at an immigration detention facility in Pinal County, Arizona operated by CoreCivic (formerly known as CCA) resulted in over 20 people contracting measles.
The outbreak was discovered in May 2016 when one detainee and an employee at the Eloy Detention Center tested positive for measles. Within two weeks, 16 cases of the highly-contagious disease had been confirmed. By the time it was officially over in August 2016 – 21 days after the last reported infection – 22 people had become ill.
“Measles is ... highly contagious yet vaccine-preventable,” said Dr. Cara Christ, director of the Arizona Department of Health Services. “It is spread through the air and through coughing, sneezing, and contact with mucous or saliva from the nose, mouth, or throat of an infected person.”
Symptoms include fever, red and watery eyes, coughing and a runny nose, but patients may also develop a rash that begins at the hairline of the head and moves down the body. The rash can appear up to 21 days after exposure, according to Dr. Rebecca Sunenshine, medical director and disease control administrator for the Maricopa County Department of Public Health.
“A person with measles is considered to be contagious as soon as symptoms start and can last four days after the rash appears,” she added.
In patients with compromised immune systems, the disease can be fatal.
Eloy’s confirmed measles cases included over a dozen detainees. Another seven were employees of CoreCivic and Immigration and Customs Enforcement (ICE).
CoreCivic is the nation’s largest private prison company. It employs about 350 people at the Eloy facility, according to Pinal County Department of Public Health Director Thomas Schryer.
The 1,550-bed Eloy Detention Center houses detainees awaiting the outcome of deportation proceedings; it also holds asylum seekers and legal immigrants eligible for deportation as a result of criminal convictions.
The measles outbreak resulted in the cancellation of court hearings, cancellation of visitation by members of the public, restricted movement within the facility, restrictions on attorney visits and a six-day moratorium on releasing detainees to the community.
Schryer said he was surprised that the outbreak didn’t spread beyond the detention center, especially considering that Arizona has an inoculation rate of less than 85 percent for measles, mumps and rubella.
“It could be that we just got lucky,” he stated – especially considering that even a month into the outbreak, more than a third of the facility’s staff had not provided proof of vaccinations to health officials.
All the detainees housed at Eloy were immunized at the beginning of the outbreak, Schryer said. But some CoreCivic workers who lacked vaccinations did not get them until after an article was published in the Casa Grande Dispatch that detailed the immunization rates among staff at the facility. As of early July 2016, Schryer reported to county supervisors that he was still having trouble getting a response from ICE employees.
“It dragged on a lot longer than we would have wanted,” he said, adding that it was staff members at the detention center, not detainees, who were “passing along the measles among each other and then going out into the community.”
ICE spokeswoman Yasmeen Pitts O’Keefe said the agency had provided vaccinations at Eloy, and for employees who refused to get them onsite, it had also provided referrals to nearby clinics along with pamphlets on the dangers of measles, plus masks and gloves to help prevent the spread of the disease.
CoreCivic said most of its employees had been vaccinated or provided proof of immunity. Those who had not were required to wear surgical masks or stay home.
Measles was declared eradicated in the U.S. in 2000, thanks to nearly universal childhood immunization. But a study – since widely discredited – linking vaccinations to autism led some parents to refuse to have their children inoculated; as a result, the disease has made a comeback. Still, according to Schryer, measles remains rare enough that most people are unfamiliar with it, and thus they midjudge its symptoms. He pointed to the case of one Eloy employee who was hospitalized for four days due to severe symptoms.
“To trigger a four-day stay in the hospitals require [sic] that you be pretty darn sick. It’s not really something to play with, and maybe they just underestimated the seriousness of it,” Schryer observed.
Pinal County public information officer Joe Pyritz said health officials had no idea how the outbreak started: “We don’t know who Patient Zero is – if it was a detainee or a person who works there.”
As debate regarding vaccinations has mounted over the past 15 years, it was an Arizonan – Dr. Jack Wolfson – who became the de facto leader of the so-called “anti-vax” movement. At the peak of a 2015 measles outbreak that spanned seven states, Woflson told a TV news reporter, “We should be getting measles, mumps, rubella, chicken pox, these are the rights of our children to get it.”
But the Eloy outbreak apparently did not rile anti-vaccination supporters, according to Pyritz. “Believe it or not, I haven’t heard anything about it,” he said. “I kind of expected that, though. Maybe the anti-vaxxers are getting the message.”
Sources: www.trivalleycentral.com, www.azcentral.com, www.rawstory.com, Business Insider, Phoenix New Times