A Measlely Journey Through Social Media

Last night and today I was immersed in an interesting social media adventure that, at once, concretized the good, the bad, and the ugly of the medium.

As everyone knows, the U.S. is in the midst of a measles outbreak that has logged 141 cases so far in 2015. Pennsylvania, fortunately, has only had one case but it is only a matter of time before more accrue.

I am a member of a Facebook group whose mission is to improve vaccination rates in the state and seek an end to the philosophical exemption to school vaccination.  Last night, a message on the page alerted members that a mayor of a Pittsburgh suburb had announced on his publicly visible Facebook page that his fully vaccinated son was diagnosed with measles. Such an announcement set off a storm of questions in my and others’ mind including:

·      How was the diagnosis made?

·      How sick was the child?

·      What was his exposure history?

·      Were appropriate public health interventions taking place?

There had been no formal announcement of a case--possible, probable, or confirmed—from public health authorities as there had been with other instances.

The next day the mayor publicly tweeted and posted on Facebook that the diagnosis was made at an urgent care center without any laboratory testing.

This immediately triggered several more thoughts centered on stand-alone urgent care centers  (i.e. those not affiliated with a hospital). In general, I support these facilities and many excellent health care providers work at them. However, one shortcoming that I have noted is that they are not particularly well integrated into the public health emergency apparatus as they tend not to be part of health care emergency coalitions (unless they are owned by a hospital system)—a fact my colleagues and I noted in a paper focused on Hurricane Sandy.

Even a suspect measles case--let alone telling a patient they have measles—no matter how unlikely it is, should trigger notification of appropriate public health authorities because of the need for appropriate testing (PCR), isolation, a contact investigation, school notification, and the need to administer post-exposure prophylaxis to those not vaccinated.

The mayor’s follow-up tweet and postings confirmed what I thought when he wrote that measles was highly unlikely.

The lesson to me is that responsible health care providers, in all settings, need to take the right actions at the point-of-care and communicate the level of diagnostic certainty and appropriate protective actions needed to the patient who.

Social media has immense power for improving infectious disease management but can only be harnessed if its content is based on sound information.