Updated 3:30 pm, Tuesday
A diagnosis of measles, confirmed by the Massachusetts Department of Public Health, that galvanized Martha’s Vineyard Hospital into organizing two free vaccination clinics and spurred a full-scale public health alert across the Island, was incorrect.
The change in diagnosis followed advanced testing of samples sent to the federal Centers for Disease Control (CDC) and Prevention. Tim Walsh, Martha’s Vineyard Hospital chief executive officer, said the Department of Public Health (DPH) confirmed the measles misdiagnosis in a telephone call Friday.
Mr. Walsh took a positive view of a health scare that tested hospital resources. “The good thing that happened is that some people who might not have been vaccinated did get vaccinated,” he said.
The measles scare began on June 17 when a mother brought an unvaccinated child into the hospital emergency room who exhibited symptoms consistent with measles. DPH tested blood samples, and confirmed the diagnosis on Friday, June 19.
That diagnosis set off a full-scale effort by state and local health officials to prevent the spread of the highly contagious disease. Public health investigators tracked the child’s movements and identified seven possible exposure locations, times, and dates.
Martha’s Vineyard Hospital organized two free measles immunization clinics on June 24 and 25, at which a total of 125 children and adults received vaccinations.
In a telephone conversation Monday, Mr. Walsh said the hospital had no choice but to react the way it did on the basis of the initial test results. “If you think it’s measles, you have to go with it,” he said.
In the end, Mr. Walsh said, it turned out to be a very expensive training exercise, when all the costs were factored in for staffing.
“It was a terrific training exercise,” Mr. Walsh said. “Everyone was doing what they thought was the right thing to do.”
Dr. Jeffrey Zack, director of the Martha’s Vineyard Hospital emergency department, told The Times that in essence, the blood samples resulted in two false positives. Those results combined with the patient’s clinical symptoms all pointed to measles, he said. It was not until more advanced and time-consuming testing of the patient’s urine was completed that the measles diagnosis was overturned.
Dr. Zack said the positive point is that the hospital and the community learned some lessons, and people received vaccinations. Erring on the side of caution, he said, was better than letting an outbreak gain a foothold.
He said he looks forward to a productive debriefing with the DPH and the boards of health that will result in finding ways to improve any future response. Better communication is one area that needs attention, he said.
Hospital officials learned a lot. “We are the better for it,” he said.
Citing a case in Massachusetts and a recent measles death in Washington, irrespective of the misdiagnosis, Dr. Zack said, “It’s still out there, and the world is really tiny, and I think making sure folks get vaccinated is really important.”
Scott Zoback, DPH spokesman, attributed the misdiagnosis to the complexity of the measles virus.
“Partially thanks to its vaccine-driven rarity, diagnosing measles is complex from both clinical and laboratory perspectives,” Mr. Zoback said in an email to The Times. “While final testing has not confirmed measles in the patient on Martha’s Vineyard, it is important that Public Health authorities at all levels respond immediately to suspected measles to carry initial diagnostic testing, consult with the CDC, and institute control measures that can prevent a serious outbreak.”
According to DPH, from time to time subsequent testing does not confirm measles as the cause of rash illness. Many other illnesses can cause fever and rash, but measles is especially severe, sometimes life-threatening and highly contagious.
Globally, 150,000 children die every year from measles. As it remains very common in many parts of the world, high levels of vaccination are essential to prevent imported cases from spreading, DPH said. This is particularly important on the Vineyard, which has many visitors from other countries and other states.
Massachusetts law requires vaccinations against 14 communicable diseases as a condition of enrollment in public schools. In addition to medical exemptions, Massachusetts allows exemptions on religious grounds.
Statewide, 95 percent of kindergarteners are reported as having received two doses of MMR vaccine, while on Martha’s Vineyard (Dukes County), 84 percent of kindergarteners are reported as having received two doses of MMR vaccine, according to DPH.
In the wake of last year’s measles outbreak, on Wednesday, California Gov. Jerry Brown signed a new law that will not allow parents to cite personal beliefs to reject vaccinations for children enrolled in public and private schools and daycare centers.