Brian Altonen, MPH, MS

Dutchess County Department of Public Health Responds to Isolated Measles Case.  This was also the case, nearly 100 years before . . . 

Source: hudsonvalleynewsnetwork.com

A review of the measles flow in the Hudson valley in 1917 depicts events that relate to those of today.  In 1917, a measles epidemic struck this county, producing most of its victims in the southernmost urban center of beacon, followed by the culturally unique population in Rhinebeck, N.Y.  What is interesting here is how much the probability for a measles outbreak back then coincide with what is happening today, both for very similar human behavior and cultural reasons, not because of population density reasons.     

When I returned to my local materials on the local epidemics, my initial expectation was that since Poughkeepsie was the primary commercial / industrial city for this region for much of the 19th century, that this epidemic would take a logical migration route into this county focused very much upon urban population density features.  However, I immediately learned that such behavior was not the case back in 1917, when measles struck this county and managed to infect a total of 245 people (26.9 / 10,000, not age adjusted), two thirds of which were all in the city of Beacon (where I reside).     

So why these differences?   

The city of Beacon is the most frequently traveled destination for early 20th C New York City folk searching for a healthy climate and taking advantage of the retreat facilities established for their use within the local Hudson Highlands.  (It was after all the mountain cure, sanitation period, anti-tuberculosis era.)     

But more important, the largest urban setting, Poughkeepsie, did not rank second to Beacon in terms of Measles.  In fact, it had 1/30th the number of cases. (Was this due to great preventon work going on?)   

The second region for the largest number of cases of measles in the county 98 years ago was Rhinebeck, a village at the northern end of the county and just south of the current quarantine case.     

What makes Rhinebeck area stand out as a potential site, today as in back then, is its cultural heritage.   

Just three years ago, a foreign case came into this region by way of international travels, infecting a childcare facility just across the river in New Paltz.  New Paltz and Rhinebeck are both very "post-modern" in their ways of conceptualizing and practicing personal health care.  The variety of mindbody movements have their major followers in this region (the Omega Institute is a couple of miles away).  The New Paltz State University setting is, need I say, very much "progressive" and "post-modern" in how the community its complementary-alternative medical beliefs and faiths.     

Thus population density alone is not the prime indicator for how a disease can impact a region.  Cultural attributes play a very important role in the local disease diffusion process.  In Disneyland California, as in the Hudson Valley, international travel is a primary concern of local public health officials. Disney’s case 0 is suspected to be from Mexico. The 2012 event was due to international travels.  The late 1980s cases of measles in Rhinebeck may also have this unique international feature to its history.  But one thing’s for sure–the combined rural settings around Rhinebeck and the popular CAM and cultural "explorers" residing in this region make it an interesting region to research, especially when it comes to studying the interactions of Darwinian and Neo-Darwinian features with infectious disease behavior and diffusion.

See on Scoop.it – Medical GIS Guide