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Good afternoon and thank you for joining us this afternoon. You should have received our

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news release. DHS confirms two cases of measles in Vernon County. We have also linked to that

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in the chat and it's also available on the DHS website. And joining us to answer your

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questions today are Dr. Ryan Westergaard, the Chief Medical Officer in the DHS Bureau of

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Communicable Diseases and Dr. Stephanie Shower, the Wisconsin Immunization Program Manager.

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And we'll begin this afternoon with remarks from Dr. Westergaard.

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Good afternoon and thank you for joining us today. Today we're at the Wisconsin Department

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of Health Services. We are providing an update on the measles cases in Wisconsin. As of today,

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we're reporting 166 cases of measles in Wisconsin during 2026. There have been 161 cases linked

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to the ongoing outbreak in southwest Wisconsin. Additionally, yesterday DHS reported one

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confirmed case of measles in a marathon county resident and today we're reporting two laboratory

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confirmed measles cases in Vernon County. One in a Vernon County resident and one in an

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out-of-state traveler who is visiting Vernon County. The investigation by our colleagues

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in Marathon County has identified out-of-state travel as the likely source of measles exposure

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for the person diagnosed in that county. And in Vernon County, our local public health

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partners are currently gathering information about the new cases to determine if there is

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a connection to any previously confirmed Wisconsin cases. These investigations are important because

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it's a reminder that measles outbreaks are occurring in multiple locations around the

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United States. People traveling to and from those places can be at risk for infection

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if they're not vaccinated. Every time a case of measles occurs in a community, it creates

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an opportunity for the virus to spread, especially so in communities where vaccination coverage

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is low. Our message to the people of Wisconsin today is to make sure that you and your family

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are protected against measles by being vaccinated. Two doses of the measles, mumps, rubella vaccine

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or MMR vaccine are about 97% effective at preventing infection and they provide lifelong

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protection. Our numbers here in Wisconsin illustrate this of the 166 cases of measles

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we've reported this year. More than 99% of them have occurred in unvaccinated people.

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The MMR vaccine is safe and it's the best tool we have for preventing the spread of

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measles in Wisconsin. Getting more people vaccinated is essential for preventing single

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cases of measles from turning into small outbreaks and from preventing small outbreaks from turning

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into large ones. While this outbreak responses underway will continue to work with our local

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partners monitoring additional cases, providing MMR vaccine to anyone who needs it and will

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share more information as it becomes available. That will be happy to take your questions at this time.

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Thank you and to start, we'll take two questions and if there's time that we'll come back around

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for any additional questions. And our first question today belongs to Hope Kerwin from

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Wisconsin Public Radio. Hope. Thank you very much. Dr. Westergaard, I know you just said that

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we are still investigating whether the Vernon County cases are related to other cases, but

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I did want to ask because of the proximity to this ongoing outbreak we see in southwestern Wisconsin.

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If there is, you know, any indication or any, if your agency is kind of taking any steps,

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you kind of put those pieces together to see if those are related. We do. Each individual case

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gets investigated by the local staff in the health department in that in that jurisdiction.

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We understand where people have traveled and with whom they've been in contact and if we

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identify a link, an epidemiological link between a place or an individual in another county,

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then we can definitively say that. So that process is underway right now. The other thing I could

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say about is how we're coordinating their response. We centrally here at DHS convene health officers

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and staff from all of our local agencies on a regular basis using Zoom and can share

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information. We all use the same electronic disease reporting database so we can share

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information that way as well. So that is a big part of this to understand when and how those

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connections occur. Another question, Hope? Yes, thank you. You know, it's been acknowledged that

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this outbreak we see in southwestern Wisconsin is really, you know, affecting pockets of the

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population with low vaccination rates. And just, you know, given that, I'm curious if you could

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speak to the kind of the trajectory of this disease in Wisconsin. You know, do we expect it to continue

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to spread rampantly or continue to spread because of under vaccination in our state?

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Yeah, well, we're certainly using all of the tools that we have to prevent it from spreading

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further. But as you mentioned, we have levels of vaccination that are below 90%.

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The standard that we talk about is 95% as being a level where it's very, very unlikely for a

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single case to result in community transmission. So most counties in Wisconsin are below that

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threshold. So it's not surprising if a single case from a travel associated case spreads to

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others in the community. But there's things we can do to minimize that. And so it's not a foregone

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conclusion. The steps of investigation that result in advice, sometimes post-exposure prophylaxis

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for with MMR vaccine isolation and quarantine. Those are the things that at any level of

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vaccine coverage we can still do to minimize the risk. So we're not treating it as inevitable

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that we're going to have a much larger outbreak than we currently have. And we're working really

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hard to keep it as small as possible. And Dr. Mr. Grant, I would also add that many of our

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local health departments, as part of the response, are offering and providing MMR. They are finding

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that the interest in uptake in vaccine for people who were previously unimmunized has increased. And

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so that is a key part of what we're doing and that they are not only providing doses in the

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community, but some of them are working to provide them or have plans to provide them in

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schools. So that is a key strategy to bringing some of those pockets up in terms of their levels

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of protection. Thank you. Now to Erica Edwards from NBC News. Erica?

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Please, no, you actually just answered my question. I was really looking at the trajectory of what

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you're seeing in the state, but I think you've answered that. Thank you.

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Thank you. Now to Maddie Hime from the Milwaukee Journal Sentinel. Maddie?

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Yeah, thank you. I am wondering, you know, like you said, this outbreak is over 160 cases. It's

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one of the largest outbreaks now that we're seeing in the country. I'm wondering how it's possible

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that there are no broader public exposures at this point. I know that something that DHS has

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said repeatedly in press releases, and I'm wondering just given the number of cases how

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that's possible at this point. Yeah, thanks. I'll be happy to explain that.

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When we approach a single case or a household or a cluster of cases, we sort of approach it the

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same way with by investigating individual places, people where exposure may have occurred. And then

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the critical next step is notifying people of their exposure so that they can receive

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vaccine if they're not already vaccinated to prevent disease.

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Our strategy is always to do that privately, confidentially, and one-on-one basis. And so when

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we say that there's no public exposure notification, what we're saying is that when exposures have

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occurred, our local investigators have been able to do outreach to the individuals directly.

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And that's always preferred. So if there's a public location where a person was known to be

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present while they were infected with measles in their infectious period, we would do a public

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notification if and only if we don't have the ability to reach out people in those specific

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places that we knew they were there. So a large gathering or a public place like a grocery store.

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Now, we only can report those when we know about them, so we also can't say they're for sure

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have not been public exposures. But our strategy is to number one, notify individuals who may be

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exposed and then do that second level of public notification when it's the only way to make

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people aware. But so we approached it that way.

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Is there a question, Maddie?

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Yeah, thank you. I'm wondering if you could speak, Dr. Restagard, to any specific outreach

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you're doing to the Amish and Mennonite populations.

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Yeah, that's also a good question. So the around the countries, close-knit communities,

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including Amish and Mennonite have been affected in many other states.

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Wisconsin, those communities are here. Our local health officers in many of our

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counties, any of our county health departments, have relationships with those communities

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and are proactively doing outreach, calling on, you know, calling on household, providing

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vaccines, offering vaccines at schools and other places to try to make, to try to make,

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spread the word of the risk and to try to minimize risk of exposure. So they are, we, you know,

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consider doing, you know, important members of our community that we do know in other places

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have had a lower vaccination rate. So our local health departments have cultivated those

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relationships that are actively doing outreach, not just during outbreaks, but during, you know,

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during regular times as well to try to encourage the uptake of vaccines.

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You've now to Erin McGroady from The Cat Times, Erin.

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Hi, thank you. My first question is for Dr. Shower. You had mentioned earlier that we've seen

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an uptick in interest in the MMR vaccine. Could you explain that a little bit more? Is that from

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folks who have already been exposed in, you know, the area of Southwestern Wisconsin where

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this outbreak is happening or what are sort of the contributing factors there?

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Yeah, I think most of it is people are aware that we have measles, you know, in Wisconsin. And I

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think they're concerned. I think the message about, you know, checking your vaccination record

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to see if you're protected or if you know you're not really that there is something that you can do

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proactively. And so health departments are being contacted through all sorts of folks in the,

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you know, in their communities. We also are, you know, seeing that providers are continuing a

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health care, traditional health care providers are also providing MMR as kids are coming in. So

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it's just, I think the awareness of measles both in Wisconsin as well as nationally has raised that.

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And I think it's helping to promote the interest and, you know, as a state, we're trying to

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ensure that all those needs are met and continuing to provide vaccine to local health departments to

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to use so that they don't miss any opportunities and we can protect folks. So

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Mr. Aaron. Yeah, this is for Dr. Westergaard. This is obviously a significant outbreak happening

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in southwestern Wisconsin. Could you talk a little bit about how these numbers compare to past years

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and how much larger these case counts are if they are?

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Yes, that's an important point for perspective. The last time that we've had

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more than even 50 cases in it in a year was more than 35 years ago. If you go to 1989 to 1991,

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which when there was a multi-year increase across the whole country of measles. And the interesting

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historical point is that that last resurgence of measles in this country in 1991 was the impetus

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for the recommendation to get two doses of MMR instead of just one. We mentioned in the intro

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that the MMR vaccine is highly effective. As far as vaccines go, 97% effective if you get both

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doses, only about 93% effective if you get one. The measles is so highly contagious that even

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that window allowed for a resurgence across the country. And I think there were many hundreds of

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cases in Wisconsin during those years. After the recommendation for two doses of MMR and became

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the standard before our kindergarten, we essentially eliminated transmission of measles

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to virus in this country like the WHO has a certification of measles elimination. So it's not

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to say that there were never any measles cases in the country. But when they were, they were

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generally linked to travel and there wasn't ongoing person to person spreader than this country.

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So that was a really big deal in 2000, the year 2000 when the United States had achieved

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measles elimination status. And in every year since then, if there were cases, there's, you know,

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ones to most of the years prior to 2021 in Wisconsin, we would have zero or one cases and they would

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be travel associated. So just having a small outbreak of 5 to 10 is very, is exceptional by

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historical standards over the past 35 years. And so this is far beyond that. In the country,

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there's over 3,000 cases this year and you get the same historical context. You have to go back

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to 1991 for there have been more than 1,000 cases. So we're in a place where we haven't been in quite

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a few years, decades, and it speaks to the importance of vaccination because it can directly connect

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the decline in vaccine coverage to the risk that cases, you know, small cases and small

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outbreaks become larger cases. So, so that's how we achieved that, measles elimination status was

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through routine 2-dose series of MMR vaccine and how we're going to get back there is going to be,

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we need to rededicate ourselves as a community to get vaccine coverage back up to the, to those

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high levels. Otherwise, there's a risk that measles is going to continue to smolder in the

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community. And it's really, it's, it's really, you know, a triumph of medical science that we have

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a tool that can eliminate such a contagious virus from the, from the community. And so what we,

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our view in public health is that everything we do to encourage our systems and our communities

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to work together to try to get back to that point is going to be great for, you know, preventing

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illness and saving lives. Thank you. Yeah. And now to Maddie Dippenfallar from WBAYTV in Green Bay.

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Maddie? Yeah, so my first question is measles hangs in the air for up to two hours after an

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infected person leaves the room. Our local urgent care and ERs in these affected counties seeing

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unannounced walk-ins and how is that handled? You know, for the Dr. Shower for that room.

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Sure. Yeah. That's a great question. And your right measles is one of the most infectious

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agents out there. And to that point, our local health care partners have been preparing. They're

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aware of this. I think we've been very fortunate that when people have been seeking care that they've

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called ahead, the information that we put out is, it is important to seek care. But please

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phone ahead. Call your doctor, call the ER and let them know so that they can take the proper

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precautions. So the amount of exposures within health care facilities has been

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relatively, has been minimized, which is really great to continue. We want people to get the care

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and the health entities are ready for it, as long as they have some of that advanced warning.

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So continue to recommend that if people think they have measles, please phone ahead and let

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the health care provider know and they'll give you instructions about how you can safely be seen

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and tested. Another question, Maddie? Yes. I think it was mentioned a little bit before that

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if you have been exposed, you might still have the chance to be vaccinated. Is there like a

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timeframe of like how soon you should get treated or vaccinated post exposure for that to be effective?

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Yeah, so that's it's typically within three days you can get the MMR vaccine. So three days from

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exposure that seems like a long time and it goes by pretty quickly. But we are fortunate that if

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someone is aware of an exposure and they are susceptible that they call their doctor right away,

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most people can get the vaccine. There are some high risk individuals who would need an immunoglobulin,

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which is a different preparation but can still provide protection. So really important if you

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think you've been exposed and you're high risk or you don't, you're unsure about your immune status

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to call right away. Thank you. Now to Deidra McPhilips from CNN. Deidra? Hi, thanks so much for your time

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today. Secretary Kennedy said that Wisconsin is one of a few states that have requested an

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FDA. I was wondering when that request went in and what that help has looked like from the CDC.

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Yes, that was, Stephanie may have the exact dates. It was about about three weeks ago and I

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believe we we shared some of this information publicly at previous announcement but it was at

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the beginning it was the first week of the Southwest Wisconsin outbreak and we had a team of

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CDC epidemiology officers who came and assisted our central team here at DHS and our local health

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department partners in the three counties that were involved. It was really helpful for building

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capacity, learning from the experience of the outbreak response in other states that have

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happened over the past several years and building an organizational framework where we can stay in

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communication with each other and really doing, you know, just getting, getting our local staff

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equipped to do the work that needed to be done. They were deployed here for two weeks. Everyone

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found that it was very, very useful and then they returned to their headquarters but remained to

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be, sort of remain a resource for us when we need them when we have technical questions and so forth.

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Is there a question, Deidra?

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Oh, no, thank thank you so much for that.

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Welcome. Not to Meryl Hubbard from TMJ4 in Milwaukee, Meryl.

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Hi, yeah, thank you so much for your eyes this time today. I really appreciate it. I was curious

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if you could shine a light on child vaccination rates in the state of Wisconsin and more specifically

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if you can in kind of the southeast Wisconsin region or coming out of Milwaukee County but

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we're also our viewing areas. Kenosha, we're seeing Washington. Just would love to know if

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there's, you know, kind of the child vaccination rates in this area and any message that you have

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for parents, especially as we're in the midst of back to school a month and I'm sure lots of

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kids are picking up lots of germs at this time. Yeah, so we do have county immunization rates on

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our website and that includes for one dose by 24 months of age as well as other age groups.

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And I think what you'll see in, you know, the southwest part of the state is you see across the

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state is that there are pockets where the coverage is lower and there are pockets where the coverage

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is much higher and so it really is a patchwork and so I think the message is making sure that

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your child is up to date. School nurses are doing that now. The measles, mumps,

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rubella vaccine is part of the requirements for school attendance and so they are looking to ensure

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that children have that vaccine on board and so school nurses may be reaching out. As I noted,

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we do have a number of health departments that are partnering with schools to provide

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vaccines including MMR so kids who are not yet up to date can get caught up. But it really is a,

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well, it's important to look at the overall statewide average which is about 85% or so of

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children have MMR. What's really important is that more local focus and what's going on in your

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community is really a more of an important driver so really recommending that people check

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records and avail themselves of vaccine as they head back to school so that this is one less thing

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that they have to worry about. Another question, Meryl. Oh, it's all like you. Thank you.

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Now to Judith Ruiz Branch from Wisconsin News Connection. Judith, do you have a question?

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Judith from Wisconsin News Connection? Okay, moving on to Tegan King from the Wisconsin

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State Journal. Tegan, do you have a question? Yeah, I do. Thank you. I know you talked a little

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bit already about sort of the trajectory of the measles cases here in Wisconsin already but I was

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curious going off of that like what it sort of looks like right now if you can tell if cases are

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still ramping up at all or have we maybe leveled off and if not when or what would it take, I guess,

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for that to finally sort of slow down a little?

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Well, I'd say similar to our vaccination coverage it's the best way to answer that question with

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real data is to look at our website where we plot the curve of how when we've the data which we

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reported cases so you can see that the timing a lot goes into determining when outbreak is

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over and the biggest thing is like is when, you know, our new communities and new pockets of

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people who are at low vaccination rates affected so the announcement today

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sort of makes the ability to predict the future of our curve more difficult because

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we had the FBA team and we had a lot of resources to investigate cases in the three southwest

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counties in the in the past month when it occurred and now we're now in a position where we have

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case in a new county where we need to start the process over hopefully we can contain it to a

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singleized travel associated case but we may learn that there there's been person-to-person

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spread and more of the exposures as we go so it really is that, you know, depends on the

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situation in the communities and we're doing all the work that we do to try to minimize the spread

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but the trajectory isn't something that is predictable it depends on how well and how early we can

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detect cases and how well we can do how good we can do getting people isolated and vaccinated

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people who are are still susceptible. Another question taken? Yeah just one more about

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the the two new cases today are you able to share like what age group they occurred in I'm curious

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if it was like a maybe a more vulnerable age group? I don't have that information handy we

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do we generally do age groups on our website Stephanie do you have the I don't have the specific

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for this but and we do you know keep that information you know protected to protect individual privacy

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but what I can tell you is that for Wisconsin 13 percent of our cases are in the zero to four

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years of age 46 percent of the cases are in the five to 17 years of age so the school age kids

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and then 42 percent are in the 18 and older so we are seeing cases across the age span and

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continue to to see and that's been fairly consistent in the last couple of weeks.

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Thank you and we have time to squeeze in one question one more question and it is in the chat

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it's from Raymond Newpert from Wisconsin Radio Network can you speak to the point of herd immunity

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for those who have autoimmune issues?

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The definition of herd immunity is defined at a community level or a population level

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and we think of it as when a population of a you know a state a country or a community

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has high enough levels of protection through vaccine derived antibody protection or previous

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infection where there's the large enough majority of people are protected that

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if it means is introduced it's unlikely to cause an outbreak right so that's so herd immunity is

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a concept that we apply to communities or populations of people the question about how that relates to

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autoimmune disease a little unclear that's typically we think about a lot of you know an individual

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patient who has an immune system disorder some and it may be relevant to in this context to think

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that people with autoimmune disorder or autoimmune disease or on immune modulating medications may

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not be able to get the MMR vaccine because of a country indication so the the connection between

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that issue is it's more important you know you could start or one of the rationales for why

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it's so valuable to have herd immunities because not every person in the community

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can get vaccinated so if there are vulnerable people you know having high enough levels of

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vaccines can protect vulnerable people by making outbreaks much less likely I don't know if I

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understood the just of the question but that's that's sort of the how those two issues are

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related in my view thank you guys so everyone you mentioned the vaccination so thank you very

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much and that will conclude today's media availability our thanks to Dr. Weistergaard and Dr. Shower and

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for all of you for participating if you have any follow-up questions you can send those to DHS

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media and please continue to monitor the DHS measles dashboard and outbreaks and investigations

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webpages for updates thank you and have a good afternoon