Contemporary Pediatrics recently spoke with Mary Koslap-Petraco, DNP, PNP-BC, CPNP, FAANP, a nationally known expert in immunization practice, about why measles infection rates have skyrocketed in her home state of New York, what’s in store for the rest of the United States during the current measles outbreak, and how physicians can engage with parents to boost immunization rates.
Dr Koslap-Petraco, pediatric nurse practitioner and community health specialist, is a nurse consultant on the staff of the Immunization Action Coalition (IAC) and CEO and primary care provider in her own private practice. She serves on the board and executive board of Vaccinate Your Family (VYF): The Next Generation of Every Child by Two, a national nonprofit organization founded in 1991 that is committed to reducing the burden of vaccine-preventable diseases in families and individuals. She is a nationally known expert in immunization practice and has been an advisor for the Centers for Disease Control and Prevention (CDC), serving on the CDC’s Advisory Board of the IAC and National Vaccine Advisory Committee. She is an adjunct clinical assistant professor at Stony Brook University School of Nursing, Stony Brook, New York, where she teaches in the Pediatric Nurse Practitioner Program. She has more than 25 years’ experience in public health and has advised local and state health departments on immunization public policies using her expertise as a public health nurse to influence system-level changes. Dr. Koslap-Petraco is a Fellow of the American Association of Nurse Practitioners.
Erin Johanek: All right Mary Beth, can you briefly explain the situation going on in New York State right now with this measles outbreak.
Dr Koslap-Petraco: Well right now here in New York we have a very big and very dangerous measles outbreak. It basically concentrated in two communities, two Orthodox Jewish communities, one in Upstate New York and one right here in lower New York, in Brooklyn. There have been a couple of cases outside those communities. So it’s not as insular as we think it is. The big problem is measles is a horrendous illness. The big thing is trying to contain and stop this. We’re also in danger of losing our designation as measles-free here in the United States which was a very hard fought battle for us in public health over the last many, many years. As we approach a thousand cases, we’ll be pretty surprised if they allow the United States to keep that measles-free designation.
Erin Johanek: So you mentioned Upstate New York and Brooklyn, so is that where the outbreak originated or is there kind of like a ground zero for this measles outbreak?
Dr Koslap-Petraco: The ground zero are those two communities. What happened was a lot of their families, with their children, traveled to countries in Europe. This particular outbreak, there’s in Ukraine, there’s a huge Orthodox Jewish community there with a temple. It’s almost like a religious pilgrimage and several community members with their children traveled there and that was the original bringing measles back to the United States. It also is coming from Israel, it’s coming from England, it’s coming from Ireland, it’s coming from France, it’s coming from Spain, it’s coming from Italy. Whoever thought a travel medicine to Western Europe? Now the first thing that we health care providers say to people who say they’re going to Western Europe is, what’s your measles immunization status? Have you had two doses if you didn’t have real measles as a child? I’m one of the dinosaurs and I’m old enough to have had measles. So the outbreak we have here in the U.S. is from unvaccinated children and adults coming back into the United States but it’s also a result of parents who don’t want to vaccinate so everybody is at risk because we have these pockets, large pockets in these communities of children and adults who are not immune to measles.