“Babies gasping for air, children needing oxygen and respiratory support, patients on ventilators. We’re seeing babies and children coming in with abdominal organ infections, liver infections, dehydration, babies who can’t take bottles,” said Dr. Evan Shirey, a pediatric infectious disease specialist at Penn State Health Golisano Children’s Hospital in Hershey. “Honestly, it was horrible to watch.”
Shirey has a 3-month-old son who is too young to get the measles vaccine. “I am experiencing the epidemic as a doctor, but I am also experiencing it as a father, and I cannot yet protect my baby with a vaccine,” he said. “It’s scary.”
Some children develop brain inflammation called encephalitis, which can take months to resolve or be irreversible in some cases, Shirey said. Others are born with congenital measles. At least two babies have died in the state.
How midwives could mitigate the spread
Nearly all states have similar laws prohibiting traditional midwives from administering vaccines without a doctor’s approval. New York recently declared a state of emergency in response to the growing measles outbreak, allowing unlicensed health care professionals with a certain level of training or licensing, including some midwives, to administer vaccines.
It’s a step Katherine Wells, public health director for Lubbock, Texas, said she wishes she had taken during last year’s outbreak among Mennonite communities in Gaines County. Using personal relationships between midwives and families would have been a good way to mitigate the spread, she said.
“During an emergency, that’s not the time to hand out your business card. You need to know these people,” Wells said. It’s critical in rural communities, she said, “especially in those that are more religious and even more distrustful of government, to find individuals in that community who can speak to that community’s way of doing things.”
Wells said she has the ability to train the public health department’s front desk staff to deliver vaccines during the outbreak. “In theory, this order could have been addressed to midwives.”
In Wisconsin, where a baby with measles died, Korina Bauer, a certified nurse midwife in Shawano County, said she was working with colleagues at the county public health department to set up a measles vaccination clinic for her clients, many of whom are Amish. The state is reporting 551 cases of measles as of Wednesday.
Bauer counsels two pregnant Amish women whose husbands were exposed to measles. “They are worried and want to know more about the symptoms,” she said. “There’s a lot of curiosity.”
Devers said the Pennsylvania Department of Health recently invited her and other midwives to an upcoming educational webinar on measles.
Gn Health
