Approved Minutes of June 25, 2025

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MINUTES ORANGE COUNTY BOARD OF HEALTH June 25, 2025 case, as well as a pertussis outbreak and there is a case of an unhoused patient with tuberculosis (TB). Ms. Stewart shared that the measles case was in a child who was visiting North Carolina from overseas and unfortunately, they visited many public places while symptomatic before seeking medical care. However, there is good contact tracing in effect, and the emergency medical care dispatch in Forsyth County had been well trained on measles, were able to recognize the symptoms, and all staff used appropriate personal protective equipment (PPE), thus limiting further exposure after the case was identified on Sunday. Ms. Stewart shared that some challenges include language barriers and finding appropriate housing/shelter when a patient with a contagious illness does not have permanent housing. Dr. Pickett wondered if the Health Department could install a tiny house behind the Whitted Building to host individuals who need temporary shelter while isolating due to a contagious illness, to which Ms. Stewart explained that contagious patients who are unhoused in Orange County are typically put in a motel or other housing with an outside door that allows direct access to a private room. • In response to measles arriving in North Carolina, the Orange County Health Department and other local health departments have been holding multiple huddles and meetings to prepare. Orange County Health Department is planning to continue promoting MMR vaccines and to post signage about recognizing measles symptoms. Ms. Stewart added that the Health Department will share information with healthcare providers, pharmacies, and individuals. • Dr. Royce asked for details about the TB case and Dr. Pettigrew explained that it was a very complicated case and that they are unsure about how long the patient has had TB. Dr. Pettigrew explained that there is an ongoing series of contact investigations, but fortunately TB has a large window (approximately eight cumulative hours) during which people can be in contact before it is considered an exposure. She added that she likes the idea of installing a tiny home for medical isolation at the Health Department. • Ms. Stewart shared that the pertussis outbreak is on the downswing as schools are now out for the summer, but around 60-70 total cases were identified. Dr. Pettigrew reiterated Commissioner Fowler's point that the high number of identified cases could have easily been caused by the awareness campaign leading to an increase in testing, as pertussis is frequently in circulation without being tested for— higher testing rates means there will be a higher number of identified cases but does not actually affect the prevalence. • The Advisory Committee on Immunization Practices (ACIP) will be convening to evaluate childhood vaccine requirements; there is a lot of concern that the current panel of required vaccines will be changed, and that any vaccines dubbed voluntary may no longer be covered by insurance. Dr. Pickett noted that her tenure on the Animal Services Board had taught her that individual counties are allowed to have more stringent requirements than the state and wondered if Orange County could maintain the current slate of childhood vaccine requirements, but Dr. Royce pointed out that they would not be covered by insurance, creating a potential equity issue. Commissioner Fowler commented that the state-funded vaccine supply exists to help cover those without insurance, but that there is no guarantee that the state supply will continue to be funded. Dr. Pettigrew noted that interpretation around vaccine requirements also presents a problem, saying that some colleges have elected to interpret the state commission- recommended vaccine requirements for school admissions as a ceiling rather than the intended floor, thus requiring fewer vaccines for enrollment than truly recommended. Ms. Stewart said that this is being watched closely, as it will have implications for all Health Department operations. • Ms. Stewart referenced some wastewater data around monitoring respiratory viruses, noting that there is currently a decrease, and shared that as of July 1 st, Orange Water and Sewage Authority (OWASA)wastewater data will also be used to track measles S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts/ June Page 7