State honors Goshen ER doctor for role in identifying measles outbreak

GOSHEN, Ind. – On Aug. 16, State Health Commissioner Gregory Larkin, M.D., honored Emergency Physician Dr. Daniel Maas for his role in identifying the measles outbreak that impacted the northeast region of the state earlier this summer.

“You were a key participant in the handling of the measles outbreak,” Dr. Larkin told Maas on his recent visit to Goshen. “Your diagnostic ability and your knowledgeable decision to contact the state were crucial to our ability to limit the number of people affected and preventing a widespread outbreak.”

Maas was presented with an award for “Excellence in Public Health” for his “outstanding contributions in promoting, protecting and providing for the health of the people of Indiana.”

The recent measles outbreak in Indiana, identified in June, infected 14 people. The measles virus causes a highly contagious respiratory disease that can lead to permanent disabilities and even death. Because measles is so contagious, even one case is considered an outbreak, according to Larkin. The number of U.S. cases remains small because of the widespread availability of the measles, mumps and rubella vaccine which was introduced in the 1960s.

When the initial carrier, who had spent time living overseas, arrived back in Indiana, the individual had a fever, a rash, and -- unknowingly -- the measles virus. This individual’s infection put into motion an outbreak investigation which impacted an entire region of the state.

During an initial visit to a physician, the individual was misdiagnosed. In the days that followed, multiple friends and family members were exposed, many of whom were unvaccinated. On June 20, five highly infectious family members, ill with fever and rash, visited Indiana University Health Goshen Hospital’s Emergency Room where Dr. Maas correctly diagnosed the patients with measles. The Indiana State Department of Health initiated a complex response to contain the outbreak.

“Doctors are our lighthouses,” Dr. Larkin said. “If we don’t have frontline doctors who can recognize infectious diseases and know to report those cases to the state, we won’t be able to put into motion the necessary actions to protect the people of Indiana.”

Following diagnosis, the infected individuals were instructed to "self-quarantine" for five days after rash onset. Unfortunately, the infected individuals had been going about life as usual up until the diagnosis without knowing they were infected with a highly contagious and potentially deadly disease.

The State Health Department activated an emergency alert message through the Indiana Health Alert Network, notifying physicians and hospitals statewide of the outbreak and brought the Centers for Disease Control and Prevention in to assist. The next day, state teams of nurses and epidemiologists were deployed to the area to help identify additional cases and contain the outbreak. Hundreds of residents had to be interviewed and their immunity to measles verified. One organization's production line even had to be closed down while the entire work force was screened by State and local health departments and vaccinated, if necessary.

The Indiana immunization registry, CHIRP, allowed physicians and nurses to quickly verify the vaccination status of exposed individuals. Thanks to the CHIRP database, the diligence Dr. Maas who properly diagnosed the first patient, the swift ISDH "boots on the ground" and the successful identification of those who needed to be quarantined or vaccinated, a potentially devastating epidemic was contained.

An uncontained outbreak could incur costs and response on a massive scale due to avoidable illness, disabilities, and even deaths, as well as the potential collapse of a community's productivity.

To learn more about immunizations and public health preparedness, please visit www.statehealth.IN.gov.

(Source: Press release from Goshen Health System Inc.)