James Mu had braced for the call that came in late January. A patient from his rural Northern California county had measles, a disease so rare there that many physicians have never treated a case. While California has some of the strictest vaccine laws in the country, conservative Shasta County’s approach during the covid pandemic stood in stark contrast with the state’s guidance. Its local leaders opposed masking and vaccine mandates, and they ousted the county public health officer, who had sought to enforce those state policies and other safety measures. A potential measles outbreak had “always been in my mind,” said Mu, an outspoken family physician who was among local doctors to sign a 2022 letter opposing covid vaccine mandates. But Mu, the county’s current public health officer, said that when his department identified the first local measles case, it acted decisively: “We forgot about fear.” They went to work, he and his team said, to painstakingly retrace the steps of nine people sickened with measles, contacting more than 600 people who may have been exposed at Costco, a sushi restaurant, sporting events, a school, or a healthcare clinic. Just one of the nine contracted measles from one of those locations, while the others were characterized by the public health department as “close contacts.” Two and a half months later, the Shasta County public health department had declared the measles outbreak over. Infectious disease experts say the rapid response executed in the mostly rural, vaccine-hesitant county offers a playbook…
