The domino-effect of a measles epidemic in the US state of Washington is gradually kicking in, with news of at least 800 students being instructed to stay home from school for several weeks on risk of exposure to the virus.
A total of 71 cases of measles have been reported in Clark County since the start of 2019, a figure that's shocking in itself but does little to reflect the far-reaching social consequences of disease outbreaks.
"School exclusions are a critical tool and public health strategy to control outbreaks of disease in school settings," state health department epidemiologist Scott Lindquist said in a statement.
"We have to be aggressive in identifying cases, isolating them and reducing public exposure to slow the spread and protect Washington residents."
Clark County has become a case study in what happens when opposition to vaccination creeps up to a significant enough level.
In 2017, barely four out of every five kindergarteners had received their full quota of measles shots before entering school, a number that's far below the national average.
Earlier this year the gamble failed to pay off. Scores of children have now succumbed to the disease, and most of them lacked proper immunisation. Worse still, the figure is expected to continue to rise.
In order to control the outbreak, school authorities have cancelled and postponed various extracurricular outings and assemblies.
Now authorities are ordering that any student who can't show evidence of vaccination needs to stay home at first sign of an infection in their school, meaning more than 800 students across the county could be missing out on education.
The directive affects more than a dozen schools, mostly in the Portland suburb of Vancouver. One school with predominantly home-schooled children instructed 243 of its students to remain off campus in late January.
This might not seem like the end of the world, but for a number of students who rely on regular contact hours, losing temporary access to expert tuition could make it harder to keep up with their peers.
"You're not going to get the education you will by being here with your peers and colleagues and my other teaching professionals," William Beville, president of the Evergreen School District's Education Association, told the Seattle Times.
"It's like if that were the case, why wouldn't all the kids stay home and just do their work remotely? It's not the same experience."
For families who work or have limited access to supervision services, the disruption can ripple out even further, costing income and savings.
The outbreak has brought the threat of measles into the spotlight for Clark County residents, prompting many concerned parents into now seeing the small risks that comes with vaccination as worth it.
State authorities have also just passed a bill tightening exemptions to vaccinations for school admissions.
Across the world, measles is making a comeback, thanks in no small part to misinformation on the balance of risk versus benefit to vaccination.
What we often imagine as a minor illness consisting of a rash and fever can have a devastating effect in communities where access to healthcare is compromised.
Last year, 33 people lost their lives as a direct result of measles epidemics that spanned Europe. The Philippines recently reported at least 70 deaths from the disease. In Madagascar, mortality has surged close to a thousand.
It's important to keep in mind the numbers describing those directly affected fail to tell us the true impact – not only in how lives are lost, but how society itself changes in response to illness.
Officially speaking, Clark County's outbreak won't be considered over until two full incubation periods – 42 days – have passed.
And even then, the epidemic won't leave the small Washington State community unchanged. Hopefully, it'll ultimately be for the better.