Oregon

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Record measles outbreak in Oregon blamed on vaccine exemptions

CDC, children, Infectious disease, measles, MMR, Oregon, Science, vaccination, vaccine exemptions, vaccines / /

consequences —

Vaccine exemptions at nearly 9% in the state, enabling sustained transmission.

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A US child infected with measles during a 2024 outbreak. The child’s cheek shows the characteristic rash associated with this viral infection.

Enlarge / A US child infected with measles during a 2024 outbreak. The child’s cheek shows the characteristic rash associated with this viral infection.

With one of the highest vaccine exemption rates in the country, Oregon is experiencing its largest measles outbreak in decades. This year’s count is now higher than anything seen since 2000, when the Centers for Disease Control and Prevention declared the highly contagious virus eliminated from the US.

Since the start of the year, Oregon has tallied 31 cases of measles, all in unvaccinated people. The cases have been accumulating in sustained waves of transmission since mid-June.

Last month, when the outbreak tally was still in the 20s, health officials noted that it was nearing a state record set in 2019. There were 28 cases that year, which were linked to a large outbreak across the border in Washington state. But, with that record now surpassed, the state is in pre-elimination territory.

“Before 2019, you have to go all the way back to the early 1990s to see case counts this high,” Paul Cieslak, medical director for communicable diseases and immunization at Oregon Health Authority, said in a statement. “The reason is, we maintained very high vaccination rates and very high population levels of immunity. Unfortunately, we’ve seen an erosion in the percentage of people who are getting vaccinated against measles.”

Vaccination decline

In 2000, when measles was declared officially eliminated, only about 1 percent of kindergarteners in the state had exemptions from childhood vaccines, such as measles. But in the years since, Oregon has become one of the states with the highest exemption rates in the country. In the 2022–2023 school year, 8.2 percent of Oregon kindergarteners had exemptions from vaccinations, according to a CDC analysis published in November. Only Idaho had a higher rate, with 12.1 percent of kindergarteners exempt. Utah was a close third, with 8.1 percent, followed by Arizona (7.4 percent) and Wisconsin (7.2 percent).

Oregon’s exemption rate has risen since then, with the exemption rate now at 8.8 percent, according to the Oregon Health Authority. Any exemption rate above 5 percent is concerning. At that threshold, even if every non-exempt child is vaccinated, a state will not be able to achieve the target of 95 percent vaccine coverage expected to prevent sustained transmission of infectious diseases.

Health officials are directly linking the rise of non-medical exemptions to the current measles outbreak, which is centered in Clackamas, Marion, and Multnomah counties. All three are in the northwestern corner of the state, with Clackamas and Multnomah in the Portland area.

“In Clackamas County, as in other Oregon counties, pockets of unvaccinated people raise risk of infection in communities where they live,” Clackamas County Health Officer Sarah Present said. “That’s why the counties reach out to every case that’s been identified and try to determine exactly where they’ve been while infectious.”

Notorious virus

Measles is among the most infectious viruses known. It is notorious for its ability to stay aloft in indoor air for up to two hours after an infected person has been present. For unvaccinated people who are exposed, up to 9 out of 10 will end up falling ill. Those who become infected are contagious from about four days before developing the tell-tale rash and four days after it erupts. Other common symptoms of the infection include high fever, runny nose, cough, and conjunctivitis (pink eye). Many children become severely ill, requiring hospitalization.

In a small percentage of cases, measles can lead to severe complications, including pneumonia, encephalitis, and a progressive neurological disorder (subacute sclerosing panencephalitis), which develops five to 10 years after an initial infection. Additionally, measles is known to cause “immune amnesia.” That is, being infected with measles virus wipes out existing antibodies and immune responses to other germs, leaving people more vulnerable to other diseases.

Two doses of MMR vaccine (measles, mumps, and rubella) are 97 percent effective against measles, and that protection is considered life-long.

So far this year, the US has logged 236 measles cases. Of those, 40 percent were in children under the age of 5, while 30 percent were in children and teens between the ages 5 and 19. Eighty-seven percent were either unvaccinated or had an unknown vaccination status. Forty-four percent (103 of 236) were hospitalized.

While Oregon’s current outbreak has broken its state records, the largest outbreak this year was in Illinois, where a total of 67 cases were reported amid spread at a Chicago-area migrant shelter.

This year’s tally is already well ahead of the total for 2023, which reached just 59 cases. It is still significantly lower than the 1,274 cases seen in 2019, when the US nearly lost its elimination status.

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Oregon governor signs nation’s first right-to-repair bill that bans parts pairing

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Right to repair —

Starting in 2025, devices can’t block repair parts with software pairing checks.

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Cables emanating from an iPhone under repair, with gloves hands holding a tweezer over the phone

Enlarge / Oregon’s repair bill prohibits companies from implementing software locks that prohibit aftermarket or used parts from being installed in their devices.

Oregon Governor Tina Kotek today signed the state’s Right to Repair Act, which will push manufacturers to provide more repair options for their products than any other state so far.

The law, like those passed in New York, California, and Minnesota, will require many manufacturers to provide the same parts, tools, and documentation to individuals and repair shops that they provide to their own repair teams.

But Oregon’s bill goes further, preventing companies from implementing schemes that require parts to be verified through encrypted software checks before they will function. Known as parts pairing or serialization, Oregon’s bill, SB 1596, is the first in the nation to target that practice. Oregon State Senator Janeen Sollman (D) and Representative Courtney Neron (D) sponsored and pushed the bill in the state senate and legislature.

“By eliminating manufacturer restrictions, the Right to Repair will make it easier for Oregonians to keep their personal electronics running,” said Charlie Fisher, director of Oregon’s chapter of the Public Interest Research Group (PIRG), in a statement. “That will conserve precious natural resources and prevent waste. It’s a refreshing alternative to a ‘throwaway’ system that treats everything as disposable.”

Oregon’s bill isn’t stronger in every regard. For one, there is no set number of years for a manufacturer to support a device with repair support. Parts pairing is prohibited only on devices sold in 2025 and later. And there are carve-outs for certain kinds of electronics and devices, including video game consoles, medical devices, HVAC systems, motor vehicles, and—as with other states—”electric toothbrushes.”

Apple opposed the Oregon repair bill for its parts-pairing ban. John Perry, a senior manager for secure design at Apple, testified at a February hearing in Oregon that the pairing restriction would “undermine the security, safety, and privacy of Oregonians by forcing device manufacturers to allow the use of parts of unknown origin in consumer devices.”

Apple surprised many observers with its support for California’s repair bill in 2023, though it did so after pressing for repair providers to mention when they use “non-genuine or used” components, and to bar repair providers from disabling security features.

According to Consumer Reports, which lobbied and testified in support of Oregon’s bill, the repair laws passed in four states now cover nearly 70 million people.

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Oregon OKs right-to-repair bill that bans the blocking of aftermarket parts

Apple, Oregon, parts pairing, Policy, repair, right to repair, Tech / /

Right to repair —

Governor’s signature would stop software locks from impairing replacement parts.

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iPhone battery being removed from an iPhone over a blue repair mat

Getty Images

Oregon has joined the small but growing list of states that have passed right-to-repair legislation. Oregon’s bill stands out for a provision that would prevent companies from requiring that official parts be unlocked with encrypted software checks before they will fully function.

Bill SB 1596 passed Oregon’s House by a 42 to 13 margin. Gov. Tina Kotek has five days to sign the bill into law. Consumer groups and right-to-repair advocates praised the bill as “the best bill yet,” while the bill’s chief sponsor, state Sen. Janeen Sollman (D), pointed to potential waste reductions and an improved second-hand market for closing a digital divide.

“Oregon improves on Right to Repair laws in California, Minnesota and New York by making sure that consumers have the choice of buying new parts, used parts, or third-party parts for the gadgets and gizmos,” said Gay Gordon-Byrne, executive director of Repair.org, in a statement.

Like bills passed in New York, California, and Minnesota, Oregon’s bill requires companies to offer the same parts, tools, and documentation to individual and independent repair shops that are already offered to authorized repair technicians.

Unlike other states’ bills, however, Oregon’s bill doesn’t demand a set number of years after device manufacture for such repair implements to be produced. That suggests companies could effectively close their repair channels entirely rather than comply with the new requirements. California’s bill mandated seven years of availability.

If signed, the law’s requirements for parts, tools, and documentation would apply to devices sold after 2015, except for phones, which are covered after July 2021. The prohibition against parts pairing only covers devices sold in 2025 and later. Like other repair bills, a number of device categories are exempted, including video game consoles, HVAC and medical gear, solar systems, vehicles, and, very specifically, “Electric toothbrushes.”

Apple had surprised many with its support for California’s repair bill. But the company, notable for its pairing requirements for certain repair parts, opposed Oregon’s repair bill. John Perry, a senior manager for secure design at Apple, testified at an Oregon hearing that the pairing restriction would “undermine the security, safety, and privacy of Oregonians by forcing device manufacturers to allow the use of parts of unknown origin in consumer devices.”

Perry also noted Apple’s improved repair workflow, which no longer requires online access or a phone call to pair parts. Apple devices will still issue notifications and warnings if an unauthorized screen or battery, for example, is installed in an iPhone.

Disclosure: Kevin Purdy previously worked for iFixit. He has no financial ties to the company.

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“Very sick” pet cat gave Oregon resident case of bubonic plague

bubonic plague, cat, CDC, fleas, infection, infectious diseases, Oregon, plague, rodents, Science, yersinia pestis / /

Surprise plague —

The person’s cat was reportedly extremely ill and had a draining abscess.

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A cat, but not the one with plague.

Enlarge / A cat, but not the one with plague.

An Oregon resident contracted bubonic plague from their “very sick” pet cat, marking the first time since 2015 that someone in the state has been stricken with the Black Death bacterium, according to local health officials.

Plague bacteria, Yersinia pestis, circulates cryptically in the US in various types of rodents and their fleas. It causes an average of seven human cases a year, with a range of 1 to 17, according to the Centers for Disease Control and Prevention. The cases tend to cluster in two regions, the CDC notes: a hotspot that spans northern New Mexico, northern Arizona, and southern Colorado, and another region spanning California, far western Nevada, and southern Oregon.

The new case in Oregon occurred in the central county of Deschutes. It was fortunately caught early before the infection developed into a more severe, systemic bloodstream infection (septicemic plague). However, according to a local official who spoke with NBC News, some doctors felt the person had developed a cough while being treated at the hospital. This could indicate progression toward pneumonic plague, a more life-threatening and more readily contagious variety of the plague that spreads via respiratory droplets. Nevertheless, the person’s case reportedly responded well to antibiotic treatment, and the person is recovering.

Health officials worked to prevent the spread of the disease. “All close contacts of the resident and their pet have been contacted and provided medication to prevent illness,” Richard Fawcett, Deschutes County Health Officer, said in a news release.

Fawcett told NBC News that the cat was “very sick” and had a draining abscess, indicating “a fairly substantial” infection. The person could have become infected by plague-infected fleas from the cat or by handling the sick cat or its bodily fluids directly. Symptoms usually develop two to eight days after exposure, when the infection occurs in the lymph nodes. Early symptoms include sudden onset of fever, nausea, weakness, chills, muscle aches, and/or visibly swollen lymph nodes called buboes. If left untreated, the infection progresses to the septicemic or pneumonic forms.

It’s unclear how or why the cat became infected. But cats are particularly susceptible to plague and are considered a common source of infection in the US. The animals, when left to roam outdoors, can pick up infections from fleas as well as killing and eating infected rodents. Though dogs can also pick up the infection from fleas or other animals, they are less likely to develop clinical illness, according to the CDC.

While plague cases are generally rare in the US, Deschutes County Health Services offered general tips to keep from contracting the deadly bacteria, namely: Avoid contact with fleas and rodents, particularly sick, injured, or dead ones; Keep pets on a leash and protected with flea control products; Work to keep rodents out and away from homes and other buildings; and avoid areas with lots of rodents while camping and hiking and wear insect repellant when outdoors to ward off fleas.

According to the CDC, there were 496 plague cases in the US between 1970 and 2020. And between 2000 and 2020, the CDC counted 14 deaths.

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