WEBVTT 00:00.000 --> 00:04.680 Good afternoon and thank you for joining us this afternoon. You should have received our 00:04.680 --> 00:10.560 news release. DHS confirms two cases of measles in Vernon County. We have also linked to that 00:10.560 --> 00:15.200 in the chat and it's also available on the DHS website. And joining us to answer your 00:15.200 --> 00:20.520 questions today are Dr. Ryan Westergaard, the Chief Medical Officer in the DHS Bureau of 00:20.520 --> 00:26.280 Communicable Diseases and Dr. Stephanie Shower, the Wisconsin Immunization Program Manager. 00:26.280 --> 00:30.600 And we'll begin this afternoon with remarks from Dr. Westergaard. 00:30.600 --> 00:36.360 Good afternoon and thank you for joining us today. Today we're at the Wisconsin Department 00:36.360 --> 00:42.240 of Health Services. We are providing an update on the measles cases in Wisconsin. As of today, 00:42.240 --> 00:51.120 we're reporting 166 cases of measles in Wisconsin during 2026. There have been 161 cases linked 00:51.120 --> 00:58.280 to the ongoing outbreak in southwest Wisconsin. Additionally, yesterday DHS reported one 00:58.280 --> 01:03.720 confirmed case of measles in a marathon county resident and today we're reporting two laboratory 01:03.720 --> 01:08.920 confirmed measles cases in Vernon County. One in a Vernon County resident and one in an 01:08.920 --> 01:14.840 out-of-state traveler who is visiting Vernon County. The investigation by our colleagues 01:14.840 --> 01:20.840 in Marathon County has identified out-of-state travel as the likely source of measles exposure 01:20.840 --> 01:26.240 for the person diagnosed in that county. And in Vernon County, our local public health 01:26.240 --> 01:30.840 partners are currently gathering information about the new cases to determine if there is 01:30.840 --> 01:37.280 a connection to any previously confirmed Wisconsin cases. These investigations are important because 01:37.280 --> 01:42.280 it's a reminder that measles outbreaks are occurring in multiple locations around the 01:42.280 --> 01:47.240 United States. People traveling to and from those places can be at risk for infection 01:47.240 --> 01:52.520 if they're not vaccinated. Every time a case of measles occurs in a community, it creates 01:52.520 --> 01:58.160 an opportunity for the virus to spread, especially so in communities where vaccination coverage 01:58.160 --> 02:03.880 is low. Our message to the people of Wisconsin today is to make sure that you and your family 02:03.880 --> 02:10.640 are protected against measles by being vaccinated. Two doses of the measles, mumps, rubella vaccine 02:10.720 --> 02:18.200 or MMR vaccine are about 97% effective at preventing infection and they provide lifelong 02:18.200 --> 02:24.320 protection. Our numbers here in Wisconsin illustrate this of the 166 cases of measles 02:24.320 --> 02:29.640 we've reported this year. More than 99% of them have occurred in unvaccinated people. 02:29.640 --> 02:34.800 The MMR vaccine is safe and it's the best tool we have for preventing the spread of 02:34.800 --> 02:40.800 measles in Wisconsin. Getting more people vaccinated is essential for preventing single 02:40.800 --> 02:45.920 cases of measles from turning into small outbreaks and from preventing small outbreaks from turning 02:45.920 --> 02:50.720 into large ones. While this outbreak responses underway will continue to work with our local 02:50.720 --> 02:56.560 partners monitoring additional cases, providing MMR vaccine to anyone who needs it and will 02:56.560 --> 03:01.440 share more information as it becomes available. That will be happy to take your questions at this time. 03:01.440 --> 03:07.680 Thank you and to start, we'll take two questions and if there's time that we'll come back around 03:07.680 --> 03:12.400 for any additional questions. And our first question today belongs to Hope Kerwin from 03:12.400 --> 03:18.560 Wisconsin Public Radio. Hope. Thank you very much. Dr. Westergaard, I know you just said that 03:19.280 --> 03:24.240 we are still investigating whether the Vernon County cases are related to other cases, but 03:24.240 --> 03:29.920 I did want to ask because of the proximity to this ongoing outbreak we see in southwestern Wisconsin. 03:29.920 --> 03:37.440 If there is, you know, any indication or any, if your agency is kind of taking any steps, 03:37.440 --> 03:45.360 you kind of put those pieces together to see if those are related. We do. Each individual case 03:45.360 --> 03:51.600 gets investigated by the local staff in the health department in that in that jurisdiction. 03:51.600 --> 03:57.840 We understand where people have traveled and with whom they've been in contact and if we 03:57.920 --> 04:04.800 identify a link, an epidemiological link between a place or an individual in another county, 04:04.800 --> 04:10.240 then we can definitively say that. So that process is underway right now. The other thing I could 04:10.240 --> 04:19.520 say about is how we're coordinating their response. We centrally here at DHS convene health officers 04:19.520 --> 04:26.720 and staff from all of our local agencies on a regular basis using Zoom and can share 04:26.720 --> 04:33.760 information. We all use the same electronic disease reporting database so we can share 04:33.760 --> 04:40.240 information that way as well. So that is a big part of this to understand when and how those 04:40.240 --> 04:48.160 connections occur. Another question, Hope? Yes, thank you. You know, it's been acknowledged that 04:48.160 --> 04:52.560 this outbreak we see in southwestern Wisconsin is really, you know, affecting pockets of the 04:52.560 --> 04:58.800 population with low vaccination rates. And just, you know, given that, I'm curious if you could 04:58.800 --> 05:04.880 speak to the kind of the trajectory of this disease in Wisconsin. You know, do we expect it to continue 05:04.880 --> 05:11.520 to spread rampantly or continue to spread because of under vaccination in our state? 05:14.880 --> 05:20.800 Yeah, well, we're certainly using all of the tools that we have to prevent it from spreading 05:21.760 --> 05:29.280 further. But as you mentioned, we have levels of vaccination that are below 90%. 05:30.880 --> 05:36.720 The standard that we talk about is 95% as being a level where it's very, very unlikely for a 05:36.720 --> 05:43.120 single case to result in community transmission. So most counties in Wisconsin are below that 05:43.120 --> 05:50.240 threshold. So it's not surprising if a single case from a travel associated case spreads to 05:50.320 --> 05:54.880 others in the community. But there's things we can do to minimize that. And so it's not a foregone 05:54.880 --> 06:03.600 conclusion. The steps of investigation that result in advice, sometimes post-exposure prophylaxis 06:03.600 --> 06:11.440 for with MMR vaccine isolation and quarantine. Those are the things that at any level of 06:11.440 --> 06:17.360 vaccine coverage we can still do to minimize the risk. So we're not treating it as inevitable 06:17.360 --> 06:22.400 that we're going to have a much larger outbreak than we currently have. And we're working really 06:22.400 --> 06:28.320 hard to keep it as small as possible. And Dr. Mr. Grant, I would also add that many of our 06:28.320 --> 06:34.400 local health departments, as part of the response, are offering and providing MMR. They are finding 06:34.400 --> 06:40.880 that the interest in uptake in vaccine for people who were previously unimmunized has increased. And 06:40.880 --> 06:46.640 so that is a key part of what we're doing and that they are not only providing doses in the 06:46.640 --> 06:51.760 community, but some of them are working to provide them or have plans to provide them in 06:51.760 --> 06:58.720 schools. So that is a key strategy to bringing some of those pockets up in terms of their levels 06:58.720 --> 07:04.960 of protection. Thank you. Now to Erica Edwards from NBC News. Erica? 07:07.600 --> 07:12.080 Please, no, you actually just answered my question. I was really looking at the trajectory of what 07:12.080 --> 07:15.360 you're seeing in the state, but I think you've answered that. Thank you. 07:16.320 --> 07:20.480 Thank you. Now to Maddie Hime from the Milwaukee Journal Sentinel. Maddie? 07:21.600 --> 07:30.240 Yeah, thank you. I am wondering, you know, like you said, this outbreak is over 160 cases. It's 07:30.240 --> 07:36.080 one of the largest outbreaks now that we're seeing in the country. I'm wondering how it's possible 07:36.080 --> 07:41.440 that there are no broader public exposures at this point. I know that something that DHS has 07:41.440 --> 07:46.240 said repeatedly in press releases, and I'm wondering just given the number of cases how 07:46.240 --> 07:52.000 that's possible at this point. Yeah, thanks. I'll be happy to explain that. 07:52.960 --> 08:00.320 When we approach a single case or a household or a cluster of cases, we sort of approach it the 08:00.320 --> 08:08.240 same way with by investigating individual places, people where exposure may have occurred. And then 08:08.320 --> 08:12.640 the critical next step is notifying people of their exposure so that they can receive 08:13.200 --> 08:17.360 vaccine if they're not already vaccinated to prevent disease. 08:19.200 --> 08:28.000 Our strategy is always to do that privately, confidentially, and one-on-one basis. And so when 08:28.000 --> 08:33.600 we say that there's no public exposure notification, what we're saying is that when exposures have 08:33.600 --> 08:39.920 occurred, our local investigators have been able to do outreach to the individuals directly. 08:40.800 --> 08:48.160 And that's always preferred. So if there's a public location where a person was known to be 08:48.160 --> 08:55.440 present while they were infected with measles in their infectious period, we would do a public 08:55.440 --> 09:02.240 notification if and only if we don't have the ability to reach out people in those specific 09:02.320 --> 09:09.600 places that we knew they were there. So a large gathering or a public place like a grocery store. 09:10.560 --> 09:17.040 Now, we only can report those when we know about them, so we also can't say they're for sure 09:17.040 --> 09:23.600 have not been public exposures. But our strategy is to number one, notify individuals who may be 09:23.600 --> 09:28.800 exposed and then do that second level of public notification when it's the only way to make 09:28.800 --> 09:33.120 people aware. But so we approached it that way. 09:35.120 --> 09:36.160 Is there a question, Maddie? 09:37.200 --> 09:41.600 Yeah, thank you. I'm wondering if you could speak, Dr. Restagard, to any specific outreach 09:41.600 --> 09:45.440 you're doing to the Amish and Mennonite populations. 09:47.520 --> 09:54.000 Yeah, that's also a good question. So the around the countries, close-knit communities, 09:54.000 --> 09:57.760 including Amish and Mennonite have been affected in many other states. 09:57.760 --> 10:02.800 Wisconsin, those communities are here. Our local health officers in many of our 10:04.240 --> 10:10.880 counties, any of our county health departments, have relationships with those communities 10:10.880 --> 10:16.160 and are proactively doing outreach, calling on, you know, calling on household, providing 10:16.160 --> 10:23.040 vaccines, offering vaccines at schools and other places to try to make, to try to make, 10:23.040 --> 10:28.240 spread the word of the risk and to try to minimize risk of exposure. So they are, we, you know, 10:28.240 --> 10:33.280 consider doing, you know, important members of our community that we do know in other places 10:33.280 --> 10:38.240 have had a lower vaccination rate. So our local health departments have cultivated those 10:38.240 --> 10:43.360 relationships that are actively doing outreach, not just during outbreaks, but during, you know, 10:43.360 --> 10:48.720 during regular times as well to try to encourage the uptake of vaccines. 10:49.440 --> 10:54.240 You've now to Erin McGroady from The Cat Times, Erin. 10:55.440 --> 11:01.600 Hi, thank you. My first question is for Dr. Shower. You had mentioned earlier that we've seen 11:02.320 --> 11:09.760 an uptick in interest in the MMR vaccine. Could you explain that a little bit more? Is that from 11:09.760 --> 11:15.200 folks who have already been exposed in, you know, the area of Southwestern Wisconsin where 11:15.200 --> 11:19.760 this outbreak is happening or what are sort of the contributing factors there? 11:20.400 --> 11:27.280 Yeah, I think most of it is people are aware that we have measles, you know, in Wisconsin. And I 11:27.280 --> 11:32.160 think they're concerned. I think the message about, you know, checking your vaccination record 11:32.880 --> 11:38.080 to see if you're protected or if you know you're not really that there is something that you can do 11:38.080 --> 11:43.760 proactively. And so health departments are being contacted through all sorts of folks in the, 11:44.320 --> 11:50.480 you know, in their communities. We also are, you know, seeing that providers are continuing a 11:50.480 --> 11:55.520 health care, traditional health care providers are also providing MMR as kids are coming in. So 11:55.520 --> 12:02.000 it's just, I think the awareness of measles both in Wisconsin as well as nationally has raised that. 12:02.000 --> 12:07.920 And I think it's helping to promote the interest and, you know, as a state, we're trying to 12:08.400 --> 12:16.000 ensure that all those needs are met and continuing to provide vaccine to local health departments to 12:16.000 --> 12:21.120 to use so that they don't miss any opportunities and we can protect folks. So 12:23.120 --> 12:32.880 Mr. Aaron. Yeah, this is for Dr. Westergaard. This is obviously a significant outbreak happening 12:32.880 --> 12:39.760 in southwestern Wisconsin. Could you talk a little bit about how these numbers compare to past years 12:39.760 --> 12:43.360 and how much larger these case counts are if they are? 12:45.680 --> 12:50.400 Yes, that's an important point for perspective. The last time that we've had 12:52.000 --> 13:00.480 more than even 50 cases in it in a year was more than 35 years ago. If you go to 1989 to 1991, 13:01.280 --> 13:08.960 which when there was a multi-year increase across the whole country of measles. And the interesting 13:08.960 --> 13:18.000 historical point is that that last resurgence of measles in this country in 1991 was the impetus 13:18.000 --> 13:24.720 for the recommendation to get two doses of MMR instead of just one. We mentioned in the intro 13:24.720 --> 13:32.240 that the MMR vaccine is highly effective. As far as vaccines go, 97% effective if you get both 13:32.240 --> 13:38.160 doses, only about 93% effective if you get one. The measles is so highly contagious that even 13:39.120 --> 13:44.960 that window allowed for a resurgence across the country. And I think there were many hundreds of 13:44.960 --> 13:54.320 cases in Wisconsin during those years. After the recommendation for two doses of MMR and became 13:54.320 --> 14:01.120 the standard before our kindergarten, we essentially eliminated transmission of measles 14:01.120 --> 14:07.440 to virus in this country like the WHO has a certification of measles elimination. So it's not 14:07.440 --> 14:11.840 to say that there were never any measles cases in the country. But when they were, they were 14:11.840 --> 14:18.320 generally linked to travel and there wasn't ongoing person to person spreader than this country. 14:18.320 --> 14:25.200 So that was a really big deal in 2000, the year 2000 when the United States had achieved 14:25.200 --> 14:30.720 measles elimination status. And in every year since then, if there were cases, there's, you know, 14:30.720 --> 14:38.080 ones to most of the years prior to 2021 in Wisconsin, we would have zero or one cases and they would 14:38.080 --> 14:45.680 be travel associated. So just having a small outbreak of 5 to 10 is very, is exceptional by 14:45.760 --> 14:50.720 historical standards over the past 35 years. And so this is far beyond that. In the country, 14:50.720 --> 14:57.680 there's over 3,000 cases this year and you get the same historical context. You have to go back 14:57.680 --> 15:04.640 to 1991 for there have been more than 1,000 cases. So we're in a place where we haven't been in quite 15:04.640 --> 15:15.600 a few years, decades, and it speaks to the importance of vaccination because it can directly connect 15:16.320 --> 15:21.760 the decline in vaccine coverage to the risk that cases, you know, small cases and small 15:21.760 --> 15:27.840 outbreaks become larger cases. So, so that's how we achieved that, measles elimination status was 15:27.840 --> 15:33.920 through routine 2-dose series of MMR vaccine and how we're going to get back there is going to be, 15:33.920 --> 15:39.680 we need to rededicate ourselves as a community to get vaccine coverage back up to the, to those 15:39.680 --> 15:44.320 high levels. Otherwise, there's a risk that measles is going to continue to smolder in the 15:44.320 --> 15:53.360 community. And it's really, it's, it's really, you know, a triumph of medical science that we have 15:53.360 --> 15:58.800 a tool that can eliminate such a contagious virus from the, from the community. And so what we, 15:58.800 --> 16:02.960 our view in public health is that everything we do to encourage our systems and our communities 16:02.960 --> 16:08.160 to work together to try to get back to that point is going to be great for, you know, preventing 16:08.160 --> 16:18.080 illness and saving lives. Thank you. Yeah. And now to Maddie Dippenfallar from WBAYTV in Green Bay. 16:18.080 --> 16:24.320 Maddie? Yeah, so my first question is measles hangs in the air for up to two hours after an 16:24.320 --> 16:30.160 infected person leaves the room. Our local urgent care and ERs in these affected counties seeing 16:30.160 --> 16:37.920 unannounced walk-ins and how is that handled? You know, for the Dr. Shower for that room. 16:38.000 --> 16:42.880 Sure. Yeah. That's a great question. And your right measles is one of the most infectious 16:42.880 --> 16:47.600 agents out there. And to that point, our local health care partners have been preparing. They're 16:47.600 --> 16:53.040 aware of this. I think we've been very fortunate that when people have been seeking care that they've 16:53.040 --> 16:58.400 called ahead, the information that we put out is, it is important to seek care. But please 16:58.400 --> 17:03.120 phone ahead. Call your doctor, call the ER and let them know so that they can take the proper 17:03.200 --> 17:07.920 precautions. So the amount of exposures within health care facilities has been 17:07.920 --> 17:14.000 relatively, has been minimized, which is really great to continue. We want people to get the care 17:14.000 --> 17:20.000 and the health entities are ready for it, as long as they have some of that advanced warning. 17:20.000 --> 17:25.760 So continue to recommend that if people think they have measles, please phone ahead and let 17:25.760 --> 17:30.800 the health care provider know and they'll give you instructions about how you can safely be seen 17:30.800 --> 17:39.200 and tested. Another question, Maddie? Yes. I think it was mentioned a little bit before that 17:40.000 --> 17:45.760 if you have been exposed, you might still have the chance to be vaccinated. Is there like a 17:45.760 --> 17:51.200 timeframe of like how soon you should get treated or vaccinated post exposure for that to be effective? 17:51.680 --> 18:01.520 Yeah, so that's it's typically within three days you can get the MMR vaccine. So three days from 18:01.520 --> 18:06.880 exposure that seems like a long time and it goes by pretty quickly. But we are fortunate that if 18:06.880 --> 18:12.320 someone is aware of an exposure and they are susceptible that they call their doctor right away, 18:12.320 --> 18:19.120 most people can get the vaccine. There are some high risk individuals who would need an immunoglobulin, 18:19.120 --> 18:24.080 which is a different preparation but can still provide protection. So really important if you 18:24.080 --> 18:28.880 think you've been exposed and you're high risk or you don't, you're unsure about your immune status 18:28.880 --> 18:38.800 to call right away. Thank you. Now to Deidra McPhilips from CNN. Deidra? Hi, thanks so much for your time 18:38.800 --> 18:45.200 today. Secretary Kennedy said that Wisconsin is one of a few states that have requested an 18:45.200 --> 18:50.880 FDA. I was wondering when that request went in and what that help has looked like from the CDC. 18:53.600 --> 19:00.400 Yes, that was, Stephanie may have the exact dates. It was about about three weeks ago and I 19:00.400 --> 19:06.160 believe we we shared some of this information publicly at previous announcement but it was at 19:06.160 --> 19:14.160 the beginning it was the first week of the Southwest Wisconsin outbreak and we had a team of 19:14.960 --> 19:23.840 CDC epidemiology officers who came and assisted our central team here at DHS and our local health 19:23.840 --> 19:30.080 department partners in the three counties that were involved. It was really helpful for building 19:30.080 --> 19:38.080 capacity, learning from the experience of the outbreak response in other states that have 19:38.080 --> 19:43.760 happened over the past several years and building an organizational framework where we can stay in 19:44.240 --> 19:50.720 communication with each other and really doing, you know, just getting, getting our local staff 19:51.680 --> 19:57.760 equipped to do the work that needed to be done. They were deployed here for two weeks. Everyone 19:57.760 --> 20:05.120 found that it was very, very useful and then they returned to their headquarters but remained to 20:05.120 --> 20:10.400 be, sort of remain a resource for us when we need them when we have technical questions and so forth. 20:10.400 --> 20:13.360 Is there a question, Deidra? 20:15.200 --> 20:16.880 Oh, no, thank thank you so much for that. 20:18.080 --> 20:22.800 Welcome. Not to Meryl Hubbard from TMJ4 in Milwaukee, Meryl. 20:24.160 --> 20:29.440 Hi, yeah, thank you so much for your eyes this time today. I really appreciate it. I was curious 20:29.440 --> 20:34.640 if you could shine a light on child vaccination rates in the state of Wisconsin and more specifically 20:34.640 --> 20:39.520 if you can in kind of the southeast Wisconsin region or coming out of Milwaukee County but 20:39.520 --> 20:45.440 we're also our viewing areas. Kenosha, we're seeing Washington. Just would love to know if 20:45.440 --> 20:50.320 there's, you know, kind of the child vaccination rates in this area and any message that you have 20:50.320 --> 20:56.640 for parents, especially as we're in the midst of back to school a month and I'm sure lots of 20:56.640 --> 21:05.600 kids are picking up lots of germs at this time. Yeah, so we do have county immunization rates on 21:05.680 --> 21:13.600 our website and that includes for one dose by 24 months of age as well as other age groups. 21:13.600 --> 21:18.640 And I think what you'll see in, you know, the southwest part of the state is you see across the 21:18.640 --> 21:23.520 state is that there are pockets where the coverage is lower and there are pockets where the coverage 21:23.520 --> 21:31.200 is much higher and so it really is a patchwork and so I think the message is making sure that 21:31.200 --> 21:36.160 your child is up to date. School nurses are doing that now. The measles, mumps, 21:36.160 --> 21:43.200 rubella vaccine is part of the requirements for school attendance and so they are looking to ensure 21:43.200 --> 21:50.880 that children have that vaccine on board and so school nurses may be reaching out. As I noted, 21:50.880 --> 21:55.360 we do have a number of health departments that are partnering with schools to provide 21:56.160 --> 22:03.840 vaccines including MMR so kids who are not yet up to date can get caught up. But it really is a, 22:04.880 --> 22:10.640 well, it's important to look at the overall statewide average which is about 85% or so of 22:10.640 --> 22:17.840 children have MMR. What's really important is that more local focus and what's going on in your 22:17.840 --> 22:26.160 community is really a more of an important driver so really recommending that people check 22:26.160 --> 22:33.200 records and avail themselves of vaccine as they head back to school so that this is one less thing 22:33.200 --> 22:40.800 that they have to worry about. Another question, Meryl. Oh, it's all like you. Thank you. 22:41.440 --> 22:46.960 Now to Judith Ruiz Branch from Wisconsin News Connection. Judith, do you have a question? 22:54.160 --> 23:02.400 Judith from Wisconsin News Connection? Okay, moving on to Tegan King from the Wisconsin 23:02.400 --> 23:08.640 State Journal. Tegan, do you have a question? Yeah, I do. Thank you. I know you talked a little 23:08.640 --> 23:15.360 bit already about sort of the trajectory of the measles cases here in Wisconsin already but I was 23:15.360 --> 23:22.880 curious going off of that like what it sort of looks like right now if you can tell if cases are 23:22.880 --> 23:29.440 still ramping up at all or have we maybe leveled off and if not when or what would it take, I guess, 23:29.440 --> 23:31.920 for that to finally sort of slow down a little? 23:31.920 --> 23:42.880 Well, I'd say similar to our vaccination coverage it's the best way to answer that question with 23:42.880 --> 23:51.680 real data is to look at our website where we plot the curve of how when we've the data which we 23:51.680 --> 24:01.360 reported cases so you can see that the timing a lot goes into determining when outbreak is 24:01.360 --> 24:06.960 over and the biggest thing is like is when, you know, our new communities and new pockets of 24:07.760 --> 24:12.320 people who are at low vaccination rates affected so the announcement today 24:15.120 --> 24:23.280 sort of makes the ability to predict the future of our curve more difficult because 24:23.360 --> 24:35.120 we had the FBA team and we had a lot of resources to investigate cases in the three southwest 24:35.120 --> 24:43.360 counties in the in the past month when it occurred and now we're now in a position where we have 24:43.360 --> 24:50.320 case in a new county where we need to start the process over hopefully we can contain it to a 24:50.320 --> 24:56.080 singleized travel associated case but we may learn that there there's been person-to-person 24:56.800 --> 25:04.800 spread and more of the exposures as we go so it really is that, you know, depends on the 25:06.240 --> 25:12.880 situation in the communities and we're doing all the work that we do to try to minimize the spread 25:12.880 --> 25:19.680 but the trajectory isn't something that is predictable it depends on how well and how early we can 25:19.680 --> 25:25.920 detect cases and how well we can do how good we can do getting people isolated and vaccinated 25:25.920 --> 25:33.440 people who are are still susceptible. Another question taken? Yeah just one more about 25:34.000 --> 25:39.520 the the two new cases today are you able to share like what age group they occurred in I'm curious 25:39.520 --> 25:47.520 if it was like a maybe a more vulnerable age group? I don't have that information handy we 25:47.520 --> 25:53.920 do we generally do age groups on our website Stephanie do you have the I don't have the specific 25:53.920 --> 26:00.720 for this but and we do you know keep that information you know protected to protect individual privacy 26:00.720 --> 26:07.520 but what I can tell you is that for Wisconsin 13 percent of our cases are in the zero to four 26:07.520 --> 26:14.560 years of age 46 percent of the cases are in the five to 17 years of age so the school age kids 26:14.640 --> 26:23.440 and then 42 percent are in the 18 and older so we are seeing cases across the age span and 26:24.080 --> 26:29.200 continue to to see and that's been fairly consistent in the last couple of weeks. 26:31.440 --> 26:36.080 Thank you and we have time to squeeze in one question one more question and it is in the chat 26:36.080 --> 26:41.680 it's from Raymond Newpert from Wisconsin Radio Network can you speak to the point of herd immunity 26:41.680 --> 26:44.240 for those who have autoimmune issues? 26:50.160 --> 26:57.440 The definition of herd immunity is defined at a community level or a population level 26:57.440 --> 27:03.440 and we think of it as when a population of a you know a state a country or a community 27:04.080 --> 27:11.520 has high enough levels of protection through vaccine derived antibody protection or previous 27:11.520 --> 27:18.320 infection where there's the large enough majority of people are protected that 27:18.960 --> 27:25.280 if it means is introduced it's unlikely to cause an outbreak right so that's so herd immunity is 27:25.280 --> 27:32.720 a concept that we apply to communities or populations of people the question about how that relates to 27:32.720 --> 27:39.280 autoimmune disease a little unclear that's typically we think about a lot of you know an individual 27:39.360 --> 27:48.800 patient who has an immune system disorder some and it may be relevant to in this context to think 27:48.800 --> 27:55.200 that people with autoimmune disorder or autoimmune disease or on immune modulating medications may 27:55.200 --> 28:04.160 not be able to get the MMR vaccine because of a country indication so the the connection between 28:04.160 --> 28:11.520 that issue is it's more important you know you could start or one of the rationales for why 28:11.520 --> 28:15.520 it's so valuable to have herd immunities because not every person in the community 28:16.880 --> 28:23.120 can get vaccinated so if there are vulnerable people you know having high enough levels of 28:23.120 --> 28:29.120 vaccines can protect vulnerable people by making outbreaks much less likely I don't know if I 28:29.120 --> 28:33.520 understood the just of the question but that's that's sort of the how those two issues are 28:33.520 --> 28:40.560 related in my view thank you guys so everyone you mentioned the vaccination so thank you very 28:40.560 --> 28:46.720 much and that will conclude today's media availability our thanks to Dr. Weistergaard and Dr. Shower and 28:46.720 --> 28:51.840 for all of you for participating if you have any follow-up questions you can send those to DHS 28:51.840 --> 28:57.680 media and please continue to monitor the DHS measles dashboard and outbreaks and investigations 28:57.680 --> 29:02.160 webpages for updates thank you and have a good afternoon