Calls for Transparency Amid Measles and Whooping Cough Outbreaks in Oklahoma

Recent outbreaks of measles and whooping cough in Oklahoma have sparked demands for increased transparency from the Oklahoma State Department of Health. Currently, the state only reports measles cases on a statewide level, which has raised concerns among experts.

Infectious disease specialists argue that timely information sharing can be pivotal in curbing disease spread in communities. Dr. George Monks, a dermatologist from Tulsa and former president of the Oklahoma State Medical Association, has made several attempts over the past few months to prompt the Health Department to release more specific data. His efforts have included social media outreach, open records requests, and even appeals to the attorney general, but so far, he hasn’t seen any significant results.

“This information is vital for families in Oklahoma to make informed health decisions, whether about vaccinations or steering clear of high-risk areas,” Monks stated. “Keeping county-level measles data private could hinder our community’s response, especially since measles is highly contagious.”

This year, Oklahoma has confirmed 17 measles cases. It’s worth noting that the U.S. is experiencing its highest rate of measles cases in three decades. While Texas recorded over 800 of the 2,000 cases nationwide in the spring, South Carolina is currently facing an outbreak.

Measles is an airborne virus that’s notably contagious, manifesting through symptoms like rashes, high fevers, coughs, runny noses, and red, watery eyes. It can survive for up to two hours in a room after an infected person coughs or sneezes.

Monks initially requested county-wise data on measles cases in March, along with any communications between the state Health Department and the Centers for Disease Control and Prevention (CDC) concerning the measles issue in Oklahoma. Although he received some emails from the CDC, the Health Department cited HIPAA regulations to justify withholding county-level data.

In a letter dated October 30, the attorney general’s office supported the Health Department’s stance, stating that their response was reasonable and noting that information on their website provides some statistical data regarding measles and potential public exposure.

According to researchers from Johns Hopkins University, Oklahoma is unique in its failure to disclose measles cases at the county or regional level. Their September study published in JAMA highlighted efforts to create a U.S. Measles Tracker.

In Kansas, county-level data is only withheld if there are fewer than five reported cases, while Tennessee, Utah, and Iowa release regional data, but not by county. The researchers emphasized that identifying cases quickly is crucial for public health responses, as even a single case can signal an impending outbreak.

Oklahoma previously shared county-level measles data during the last major outbreak in 2019, when reports indicated cases in Okmulgee County.

In response to inquiries, the state Health Department maintains that their public data adequately informs local communities about potential measles exposures, offering general case statistics, vaccination rates, age ranges, and specific exposure settings identified during investigations.

“Information about identified exposure sites is critical in indicating where the risk lies, and a person’s county of residence may not fully reflect the populations at risk,” the department explained.

They also did not address queries about how other states manage to report county-level measles data, instead reiterating their interpretation of HIPAA laws and public health regulations as justification for withholding such information.

Reflections of COVID-19 Data Transparency Issues

The discussion on sharing disease data echoes the challenges faced at the beginning of the COVID-19 pandemic. Oklahoma was notably slow in providing community-level infection details back then, despite issuing county-level case data.

When COVID-19 began to spread, Oklahoma Watch requested information on local COVID-19 cases, which officials initially declined based on privacy laws, despite exemptions for de-identified data. Eventually, as the situation developed, localized data was made available on an online dashboard.

The state maintained that they used a risk-based approach for reporting COVID-19 cases, emphasizing the need for transparency in public health strategies. “For measles, sharing exact locations and times of public exposure is vital in conveying risk to the community,” they stated.

Oklahoma’s public health officials withholding county-level measles data contrasts with their approach to tracking West Nile virus, where they do report case numbers and affected counties.

“It doesn’t make sense to me,” Monks remarked. “They claim privacy concerns for measles, but this is just aggregate data. Why treat these illnesses so differently?”

The Health Department justified its decisions based on factors such as overall case counts, county populations, and the impact of case investigations.

As Monks continues to press for further disease data, he points out that the current whooping cough outbreak is the worst Oklahoma has seen in 70 years, and the measles situation is similarly unprecedented in the past 35 years. He believes the reluctance to share detailed data is more of a policy choice than a matter of public health. Some state leaders may wish to avoid conflict with federal vaccination policies.

“From a Republican perspective, there’s a tendency to shy away from pro-vaccination stances, especially in a primary context,” Monks suggested.