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>> James Barnier, thanks
very much for joining us.

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>> Thank you.
>> Measles was declared

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eliminated in the U.S. 25
years ago, but this year

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marks the most cases since
then, with spread of the

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disease to 40 states and
more than 1300 cases.

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Earlier this month,
Wisconsin reported nine

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cases in Oconto County. But
health officials say they

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believe any spread there is
contained. Still, Wisconsin

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kindergartners have one of
the nation's lowest

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vaccination rates against
measles, with less than 85%

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of them up to date on the
measles vaccine. Last year.

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That's compared to about
92.5% of kindergartners

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nationwide, according to the
CDC. We turn to Doctor James

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Conway, pediatric infectious
disease specialist at the UW

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School of Medicine and
Public Health. And thanks

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for being here.
>> Happy to be back.

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>> So with Wisconsin
vaccination rates, how at

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risk are we for measles
outbreaks?

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a sitting duck. You know, as
we see people traveling and

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introducing the disease into
various areas, all it takes

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is one person who's
incubating the disease to

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show up in an area with
under-immunized populations.

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In a way, it goes. That's
really how these things get

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started.
>> Are you surprised that we

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haven't seen that kind of
outbreak?

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surprising given our low
rates and how much travel

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people have been doing as
we've come out of Covid and

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gotten back to more normal
activity. You know, we know

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that disease gets introduced
fairly regularly. You know,

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while many of them are
related to the Texas

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outbreak, we still see cases
countries. And so all it

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takes is one person showing
up in the right place at the

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right time.
>> Now, I understand that

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Wisconsin is one of only 13
states that has a personal

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conviction waiver for
parents to opt out of the

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vaccine. Is that opt out on
the rise?

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>> Yeah, it's been debated.
You know, there are medical

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waivers in every state, and
some states also have

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religious waivers. But this
personal exemption waiver is

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something that's a little
unusual. And it really

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allows people that just have
a deep held personal

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conviction to opt out of it.
Some states are discussing

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actually allowing more of
that while other states are

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shutting it down and
actually trying to contain

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that activity.
>> So what's it like for a

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doctor like yourself to see
a preventable disease like

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this spreading?
>> Yeah. It's heartbreaking.

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I mean, I saw plenty of
measles earlier in my

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career, both in my training
here in the United States

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and in my work globally.
And, you know, as we worked

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so hard to eradicate polio
when I was younger, measles

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was really the next one on
the chopping block. And in

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the 90s, we were very
optimistic. We were getting

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closer. You know, I've seen
so many children suffer with

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this disease. Adults don't
do well with it either. And

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then having to see people
unfortunately subjected to

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this again, you know, it's
really both preventable. And

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just so unfortunate.
>> How transmissible are

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measles?
>> Measles is probably one

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of the most transmissible
things on the planet. You

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know, we talk about the fact
that you probably need about

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95% of people to be
vaccinated in any community

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to keep an outbreak from
spreading. And so when we're

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sitting well below 90%, you
know, it's really almost

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something that is
inevitable. But it is by far

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one of the most contagious
things on this planet at

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this point.
kind of the symptoms of, of

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measles, but it can be
fatal.

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1 to 2 people per thousand
are going to be killed by

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this. Probably 10% get
hospitalized. So it is, you

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know, really a very high
risk disease, especially in

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young kids, the elderly,
people with compromised

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immune systems. But even
people that survive it. I

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mean, it's a miserable
disease.

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>> And there are certain
groups that cannot get a

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vaccine. And any spread
would put those people at

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risk who who really does not
get the vaccine.

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>> Yeah. So this is one of
the few vaccines that's

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still considered a live
viral vaccine. So these are

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viruses that have been
essentially engineered to be

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less transmissible, but they
still can cause some

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symptoms in people that
don't have a good immune

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system. So people that have
had bone marrow or other

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organ transplants shouldn't
be getting these vaccines.

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Patients that are under
chemotherapy for other types

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of cancers, people that are
on immune compromising

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drugs, they just can't get
the vaccines. And so they

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really do depend on the rest
of us to essentially build a

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firewall for them.
>> Now, I learned that in

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Milwaukee, the vaccination
75%. They are now giving out

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800 doses of this vaccine.
But how at risk is a place

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like Milwaukee?
>> Yeah, so that's exactly

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the worst nightmare.
Because, you know, one of

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the things we need to
remember about measles is

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people are contagious before
they have symptoms. So 3 or

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4 days before you're
actually ill with obvious

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shedding that virus. And so
when you've got even 75 or

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80% of people immunized,
that means 1 in 5 people are

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vulnerable. Those get
transmitted. It's got a long

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incubation period. So people
can be walking around for

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weeks, not remember where
they got it. And so from a

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public health standpoint,
chasing down where it

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started and getting people
into quarantine and

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isolation is really a
nightmare.