“Babies gasping for air, children needing oxygen and respiratory support, patients on ventilators. We see babies and children coming in with infections of organs within the abdomen, their liver, dehydration, babies that can’t take bottles,” said Dr. Evan Shirey, a pediatric infectious disease physician at Penn State Health Golisano Children’s Hospital in Hershey. “It’s honestly just been horrifying to watch.”
Shirey has a 3-month-old son who is too young to get the measles shot. “I’m experiencing the outbreak as a doctor, but I’m also experiencing it as a dad, and I can’t protect my baby yet with a vaccine,” he said. “It’s scary.”
Some children are developing brain inflammation called encephalitis, which may take months to resolve or be irreversible in some cases, Shirey said. Others are born with congenital measles. At least two babies in the state have died.
How midwives could mitigate the spread
Nearly all states have similar laws barring traditional midwives from giving vaccines without a doctor’s backing. New York recently declared a disaster emergency in response to its growing measles outbreak allowing unlicensed healthcare practitioners with a certain level of training or authorization, including some midwives, to give vaccines.
It’s a step Katherine Wells, public health director for Lubbock, Texas, said she wishes she would have 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 spread, she said.
“During the emergency is not the time to be passing out your business card. You have to know those people,” Wells said. It’s critical in rural communities, she said, “especially in ones 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 had the ability to train front desk staffers at the Public Health Department to deliver vaccines during the outbreak. “Theoretically, that order could have gone to midwives.”
In Wisconsin, where a baby with measles has died, Korina Bauer, a certified nurse midwife in Shawano County, said she’s working with county Public Health Department colleagues to set up a measles vaccination clinic for her clients, many of whom are Amish. The state reports 551 measles cases as of Wednesday.
Bauer is counseling two pregnant Amish women whose husbands were exposed to measles. “They’re concerned and want to know more about symptoms,” she said. “There is a lot of curiosity.”
Devers said the Pennsylvania Health Department recently invited her and other midwives to an upcoming measles education webinar.
