Good afternoon and thank you for joining us this afternoon. You should have received our
news release. DHS confirms two cases of measles in Vernon County. We have also linked to that
in the chat and it's also available on the DHS website. And joining us to answer your
questions today are Dr. Ryan Westergaard, the Chief Medical Officer in the DHS Bureau of
Communicable Diseases and Dr. Stephanie Shower, the Wisconsin Immunization Program Manager.
And we'll begin this afternoon with remarks from Dr. Westergaard.
Good afternoon and thank you for joining us today. Today we're at the Wisconsin Department
of Health Services. We are providing an update on the measles cases in Wisconsin. As of today,
we're reporting 166 cases of measles in Wisconsin during 2026. There have been 161 cases linked
to the ongoing outbreak in southwest Wisconsin. Additionally, yesterday DHS reported one
confirmed case of measles in a marathon county resident and today we're reporting two laboratory
confirmed measles cases in Vernon County. One in a Vernon County resident and one in an
out-of-state traveler who is visiting Vernon County. The investigation by our colleagues
in Marathon County has identified out-of-state travel as the likely source of measles exposure
for the person diagnosed in that county. And in Vernon County, our local public health
partners are currently gathering information about the new cases to determine if there is
a connection to any previously confirmed Wisconsin cases. These investigations are important because
it's a reminder that measles outbreaks are occurring in multiple locations around the
United States. People traveling to and from those places can be at risk for infection
if they're not vaccinated. Every time a case of measles occurs in a community, it creates
an opportunity for the virus to spread, especially so in communities where vaccination coverage
is low. Our message to the people of Wisconsin today is to make sure that you and your family
are protected against measles by being vaccinated. Two doses of the measles, mumps, rubella vaccine
or MMR vaccine are about 97% effective at preventing infection and they provide lifelong
protection. Our numbers here in Wisconsin illustrate this of the 166 cases of measles
we've reported this year. More than 99% of them have occurred in unvaccinated people.
The MMR vaccine is safe and it's the best tool we have for preventing the spread of
measles in Wisconsin. Getting more people vaccinated is essential for preventing single
cases of measles from turning into small outbreaks and from preventing small outbreaks from turning
into large ones. While this outbreak responses underway will continue to work with our local
partners monitoring additional cases, providing MMR vaccine to anyone who needs it and will
share more information as it becomes available. That will be happy to take your questions at this time.
Thank you and to start, we'll take two questions and if there's time that we'll come back around
for any additional questions. And our first question today belongs to Hope Kerwin from
Wisconsin Public Radio. Hope. Thank you very much. Dr. Westergaard, I know you just said that
we are still investigating whether the Vernon County cases are related to other cases, but
I did want to ask because of the proximity to this ongoing outbreak we see in southwestern Wisconsin.
If there is, you know, any indication or any, if your agency is kind of taking any steps,
you kind of put those pieces together to see if those are related. We do. Each individual case
gets investigated by the local staff in the health department in that in that jurisdiction.
We understand where people have traveled and with whom they've been in contact and if we
identify a link, an epidemiological link between a place or an individual in another county,
then we can definitively say that. So that process is underway right now. The other thing I could
say about is how we're coordinating their response. We centrally here at DHS convene health officers
and staff from all of our local agencies on a regular basis using Zoom and can share
information. We all use the same electronic disease reporting database so we can share
information that way as well. So that is a big part of this to understand when and how those
connections occur. Another question, Hope? Yes, thank you. You know, it's been acknowledged that
this outbreak we see in southwestern Wisconsin is really, you know, affecting pockets of the
population with low vaccination rates. And just, you know, given that, I'm curious if you could
speak to the kind of the trajectory of this disease in Wisconsin. You know, do we expect it to continue
to spread rampantly or continue to spread because of under vaccination in our state?
Yeah, well, we're certainly using all of the tools that we have to prevent it from spreading
further. But as you mentioned, we have levels of vaccination that are below 90%.
The standard that we talk about is 95% as being a level where it's very, very unlikely for a
single case to result in community transmission. So most counties in Wisconsin are below that
threshold. So it's not surprising if a single case from a travel associated case spreads to
others in the community. But there's things we can do to minimize that. And so it's not a foregone
conclusion. The steps of investigation that result in advice, sometimes post-exposure prophylaxis
for with MMR vaccine isolation and quarantine. Those are the things that at any level of
vaccine coverage we can still do to minimize the risk. So we're not treating it as inevitable
that we're going to have a much larger outbreak than we currently have. And we're working really
hard to keep it as small as possible. And Dr. Mr. Grant, I would also add that many of our
local health departments, as part of the response, are offering and providing MMR. They are finding
that the interest in uptake in vaccine for people who were previously unimmunized has increased. And
so that is a key part of what we're doing and that they are not only providing doses in the
community, but some of them are working to provide them or have plans to provide them in
schools. So that is a key strategy to bringing some of those pockets up in terms of their levels
of protection. Thank you. Now to Erica Edwards from NBC News. Erica?
Please, no, you actually just answered my question. I was really looking at the trajectory of what
you're seeing in the state, but I think you've answered that. Thank you.
Thank you. Now to Maddie Hime from the Milwaukee Journal Sentinel. Maddie?
Yeah, thank you. I am wondering, you know, like you said, this outbreak is over 160 cases. It's
one of the largest outbreaks now that we're seeing in the country. I'm wondering how it's possible
that there are no broader public exposures at this point. I know that something that DHS has
said repeatedly in press releases, and I'm wondering just given the number of cases how
that's possible at this point. Yeah, thanks. I'll be happy to explain that.
When we approach a single case or a household or a cluster of cases, we sort of approach it the
same way with by investigating individual places, people where exposure may have occurred. And then
the critical next step is notifying people of their exposure so that they can receive
vaccine if they're not already vaccinated to prevent disease.
Our strategy is always to do that privately, confidentially, and one-on-one basis. And so when
we say that there's no public exposure notification, what we're saying is that when exposures have
occurred, our local investigators have been able to do outreach to the individuals directly.
And that's always preferred. So if there's a public location where a person was known to be
present while they were infected with measles in their infectious period, we would do a public
notification if and only if we don't have the ability to reach out people in those specific
places that we knew they were there. So a large gathering or a public place like a grocery store.
Now, we only can report those when we know about them, so we also can't say they're for sure
have not been public exposures. But our strategy is to number one, notify individuals who may be
exposed and then do that second level of public notification when it's the only way to make
people aware. But so we approached it that way.
Is there a question, Maddie?
Yeah, thank you. I'm wondering if you could speak, Dr. Restagard, to any specific outreach
you're doing to the Amish and Mennonite populations.
Yeah, that's also a good question. So the around the countries, close-knit communities,
including Amish and Mennonite have been affected in many other states.
Wisconsin, those communities are here. Our local health officers in many of our
counties, any of our county health departments, have relationships with those communities
and are proactively doing outreach, calling on, you know, calling on household, providing
vaccines, offering vaccines at schools and other places to try to make, to try to make,
spread the word of the risk and to try to minimize risk of exposure. So they are, we, you know,
consider doing, you know, important members of our community that we do know in other places
have had a lower vaccination rate. So our local health departments have cultivated those
relationships that are actively doing outreach, not just during outbreaks, but during, you know,
during regular times as well to try to encourage the uptake of vaccines.
You've now to Erin McGroady from The Cat Times, Erin.
Hi, thank you. My first question is for Dr. Shower. You had mentioned earlier that we've seen
an uptick in interest in the MMR vaccine. Could you explain that a little bit more? Is that from
folks who have already been exposed in, you know, the area of Southwestern Wisconsin where
this outbreak is happening or what are sort of the contributing factors there?
Yeah, I think most of it is people are aware that we have measles, you know, in Wisconsin. And I
think they're concerned. I think the message about, you know, checking your vaccination record
to see if you're protected or if you know you're not really that there is something that you can do
proactively. And so health departments are being contacted through all sorts of folks in the,
you know, in their communities. We also are, you know, seeing that providers are continuing a
health care, traditional health care providers are also providing MMR as kids are coming in. So
it's just, I think the awareness of measles both in Wisconsin as well as nationally has raised that.
And I think it's helping to promote the interest and, you know, as a state, we're trying to
ensure that all those needs are met and continuing to provide vaccine to local health departments to
to use so that they don't miss any opportunities and we can protect folks. So
Mr. Aaron. Yeah, this is for Dr. Westergaard. This is obviously a significant outbreak happening
in southwestern Wisconsin. Could you talk a little bit about how these numbers compare to past years
and how much larger these case counts are if they are?
Yes, that's an important point for perspective. The last time that we've had
more than even 50 cases in it in a year was more than 35 years ago. If you go to 1989 to 1991,
which when there was a multi-year increase across the whole country of measles. And the interesting
historical point is that that last resurgence of measles in this country in 1991 was the impetus
for the recommendation to get two doses of MMR instead of just one. We mentioned in the intro
that the MMR vaccine is highly effective. As far as vaccines go, 97% effective if you get both
doses, only about 93% effective if you get one. The measles is so highly contagious that even
that window allowed for a resurgence across the country. And I think there were many hundreds of
cases in Wisconsin during those years. After the recommendation for two doses of MMR and became
the standard before our kindergarten, we essentially eliminated transmission of measles
to virus in this country like the WHO has a certification of measles elimination. So it's not
to say that there were never any measles cases in the country. But when they were, they were
generally linked to travel and there wasn't ongoing person to person spreader than this country.
So that was a really big deal in 2000, the year 2000 when the United States had achieved
measles elimination status. And in every year since then, if there were cases, there's, you know,
ones to most of the years prior to 2021 in Wisconsin, we would have zero or one cases and they would
be travel associated. So just having a small outbreak of 5 to 10 is very, is exceptional by
historical standards over the past 35 years. And so this is far beyond that. In the country,
there's over 3,000 cases this year and you get the same historical context. You have to go back
to 1991 for there have been more than 1,000 cases. So we're in a place where we haven't been in quite
a few years, decades, and it speaks to the importance of vaccination because it can directly connect
the decline in vaccine coverage to the risk that cases, you know, small cases and small
outbreaks become larger cases. So, so that's how we achieved that, measles elimination status was
through routine 2-dose series of MMR vaccine and how we're going to get back there is going to be,
we need to rededicate ourselves as a community to get vaccine coverage back up to the, to those
high levels. Otherwise, there's a risk that measles is going to continue to smolder in the
community. And it's really, it's, it's really, you know, a triumph of medical science that we have
a tool that can eliminate such a contagious virus from the, from the community. And so what we,
our view in public health is that everything we do to encourage our systems and our communities
to work together to try to get back to that point is going to be great for, you know, preventing
illness and saving lives. Thank you. Yeah. And now to Maddie Dippenfallar from WBAYTV in Green Bay.
Maddie? Yeah, so my first question is measles hangs in the air for up to two hours after an
infected person leaves the room. Our local urgent care and ERs in these affected counties seeing
unannounced walk-ins and how is that handled? You know, for the Dr. Shower for that room.
Sure. Yeah. That's a great question. And your right measles is one of the most infectious
agents out there. And to that point, our local health care partners have been preparing. They're
aware of this. I think we've been very fortunate that when people have been seeking care that they've
called ahead, the information that we put out is, it is important to seek care. But please
phone ahead. Call your doctor, call the ER and let them know so that they can take the proper
precautions. So the amount of exposures within health care facilities has been
relatively, has been minimized, which is really great to continue. We want people to get the care
and the health entities are ready for it, as long as they have some of that advanced warning.
So continue to recommend that if people think they have measles, please phone ahead and let
the health care provider know and they'll give you instructions about how you can safely be seen
and tested. Another question, Maddie? Yes. I think it was mentioned a little bit before that
if you have been exposed, you might still have the chance to be vaccinated. Is there like a
timeframe of like how soon you should get treated or vaccinated post exposure for that to be effective?
Yeah, so that's it's typically within three days you can get the MMR vaccine. So three days from
exposure that seems like a long time and it goes by pretty quickly. But we are fortunate that if
someone is aware of an exposure and they are susceptible that they call their doctor right away,
most people can get the vaccine. There are some high risk individuals who would need an immunoglobulin,
which is a different preparation but can still provide protection. So really important if you
think you've been exposed and you're high risk or you don't, you're unsure about your immune status
to call right away. Thank you. Now to Deidra McPhilips from CNN. Deidra? Hi, thanks so much for your time
today. Secretary Kennedy said that Wisconsin is one of a few states that have requested an
FDA. I was wondering when that request went in and what that help has looked like from the CDC.
Yes, that was, Stephanie may have the exact dates. It was about about three weeks ago and I
believe we we shared some of this information publicly at previous announcement but it was at
the beginning it was the first week of the Southwest Wisconsin outbreak and we had a team of
CDC epidemiology officers who came and assisted our central team here at DHS and our local health
department partners in the three counties that were involved. It was really helpful for building
capacity, learning from the experience of the outbreak response in other states that have
happened over the past several years and building an organizational framework where we can stay in
communication with each other and really doing, you know, just getting, getting our local staff
equipped to do the work that needed to be done. They were deployed here for two weeks. Everyone
found that it was very, very useful and then they returned to their headquarters but remained to
be, sort of remain a resource for us when we need them when we have technical questions and so forth.
Is there a question, Deidra?
Oh, no, thank thank you so much for that.
Welcome. Not to Meryl Hubbard from TMJ4 in Milwaukee, Meryl.
Hi, yeah, thank you so much for your eyes this time today. I really appreciate it. I was curious
if you could shine a light on child vaccination rates in the state of Wisconsin and more specifically
if you can in kind of the southeast Wisconsin region or coming out of Milwaukee County but
we're also our viewing areas. Kenosha, we're seeing Washington. Just would love to know if
there's, you know, kind of the child vaccination rates in this area and any message that you have
for parents, especially as we're in the midst of back to school a month and I'm sure lots of
kids are picking up lots of germs at this time. Yeah, so we do have county immunization rates on
our website and that includes for one dose by 24 months of age as well as other age groups.
And I think what you'll see in, you know, the southwest part of the state is you see across the
state is that there are pockets where the coverage is lower and there are pockets where the coverage
is much higher and so it really is a patchwork and so I think the message is making sure that
your child is up to date. School nurses are doing that now. The measles, mumps,
rubella vaccine is part of the requirements for school attendance and so they are looking to ensure
that children have that vaccine on board and so school nurses may be reaching out. As I noted,
we do have a number of health departments that are partnering with schools to provide
vaccines including MMR so kids who are not yet up to date can get caught up. But it really is a,
well, it's important to look at the overall statewide average which is about 85% or so of
children have MMR. What's really important is that more local focus and what's going on in your
community is really a more of an important driver so really recommending that people check
records and avail themselves of vaccine as they head back to school so that this is one less thing
that they have to worry about. Another question, Meryl. Oh, it's all like you. Thank you.
Now to Judith Ruiz Branch from Wisconsin News Connection. Judith, do you have a question?
Judith from Wisconsin News Connection? Okay, moving on to Tegan King from the Wisconsin
State Journal. Tegan, do you have a question? Yeah, I do. Thank you. I know you talked a little
bit already about sort of the trajectory of the measles cases here in Wisconsin already but I was
curious going off of that like what it sort of looks like right now if you can tell if cases are
still ramping up at all or have we maybe leveled off and if not when or what would it take, I guess,
for that to finally sort of slow down a little?
Well, I'd say similar to our vaccination coverage it's the best way to answer that question with
real data is to look at our website where we plot the curve of how when we've the data which we
reported cases so you can see that the timing a lot goes into determining when outbreak is
over and the biggest thing is like is when, you know, our new communities and new pockets of
people who are at low vaccination rates affected so the announcement today
sort of makes the ability to predict the future of our curve more difficult because
we had the FBA team and we had a lot of resources to investigate cases in the three southwest
counties in the in the past month when it occurred and now we're now in a position where we have
case in a new county where we need to start the process over hopefully we can contain it to a
singleized travel associated case but we may learn that there there's been person-to-person
spread and more of the exposures as we go so it really is that, you know, depends on the
situation in the communities and we're doing all the work that we do to try to minimize the spread
but the trajectory isn't something that is predictable it depends on how well and how early we can
detect cases and how well we can do how good we can do getting people isolated and vaccinated
people who are are still susceptible. Another question taken? Yeah just one more about
the the two new cases today are you able to share like what age group they occurred in I'm curious
if it was like a maybe a more vulnerable age group? I don't have that information handy we
do we generally do age groups on our website Stephanie do you have the I don't have the specific
for this but and we do you know keep that information you know protected to protect individual privacy
but what I can tell you is that for Wisconsin 13 percent of our cases are in the zero to four
years of age 46 percent of the cases are in the five to 17 years of age so the school age kids
and then 42 percent are in the 18 and older so we are seeing cases across the age span and
continue to to see and that's been fairly consistent in the last couple of weeks.
Thank you and we have time to squeeze in one question one more question and it is in the chat
it's from Raymond Newpert from Wisconsin Radio Network can you speak to the point of herd immunity
for those who have autoimmune issues?
The definition of herd immunity is defined at a community level or a population level
and we think of it as when a population of a you know a state a country or a community
has high enough levels of protection through vaccine derived antibody protection or previous
infection where there's the large enough majority of people are protected that
if it means is introduced it's unlikely to cause an outbreak right so that's so herd immunity is
a concept that we apply to communities or populations of people the question about how that relates to
autoimmune disease a little unclear that's typically we think about a lot of you know an individual
patient who has an immune system disorder some and it may be relevant to in this context to think
that people with autoimmune disorder or autoimmune disease or on immune modulating medications may
not be able to get the MMR vaccine because of a country indication so the the connection between
that issue is it's more important you know you could start or one of the rationales for why
it's so valuable to have herd immunities because not every person in the community
can get vaccinated so if there are vulnerable people you know having high enough levels of
vaccines can protect vulnerable people by making outbreaks much less likely I don't know if I
understood the just of the question but that's that's sort of the how those two issues are
related in my view thank you guys so everyone you mentioned the vaccination so thank you very
much and that will conclude today's media availability our thanks to Dr. Weistergaard and Dr. Shower and
for all of you for participating if you have any follow-up questions you can send those to DHS
media and please continue to monitor the DHS measles dashboard and outbreaks and investigations
webpages for updates thank you and have a good afternoon