At the beginning of this year, we learned about two confirmed cases of measles: one in Oregon and one in Washington. Now there is increasing measles activity throughout the Portland/Vancouver area.

If your children have been fully vaccinated against measles (two doses of MMR), their risk of becoming sick is very low. Risk is highest for people who are not vaccinated, unvaccinated pregnant women, infants younger than one, and immunocompromised individuals.

The single best way to protect your kids from vaccine-preventable diseases like measles is to make sure they’re immunized on schedule. MMR is very safe and effective and could absolutely save your child’s life.

Confirmed Measles Cases Continue to Grow

As of 1/25/2019, there are 30 confirmed cases of measles. 26 of the confirmed cases involve children who have not been vaccinated.

Clark Country recently declared this outbreak a public health emergency.They have set up a hotline for people to call with questions related to the measles investigation. The number is 360.397.8021 and is staffed from 9am to 7pm daily.

Exposure locations across the Portland/Vancouver area range from hospitals, medical offices, schools and stores.  See more about specific locations and times of potential exposure.

Public Health is requiring exclusion of students and staff without documented immunity to measles from only those schools identified as possible exposure sites. Students and staff excluded from those identified schools are also excluded from other schools, child care and other congregate settings. Students and staff at schools where measles exposure did not occur are not impacted by exclusions.

Measles Symptoms

Symptoms typically appear within one to three weeks of exposure and include:

• Fever
• Cough
• Runny nose
• Red, watery eyes
• Blotchy, red rash that starts on the face and spreads to the rest of the body

People with measles are contagious prior to showing any symptoms up until four days after the rash appears.

Here’s what to do:

Please call us if you believe your child may have been exposed. It is important to remain at home so as not to infect other individuals.

Contact us immediately if your child develops measles symptoms, even if your child has been immunized. We’ll help come up with a plan to safely see your child without exposing other families.

We’re also happy to answer your questions about measles infection or any questions or concerns you have about this information. Another great resource is your county health department:

• Clark County Public Health: 360.397.8182
• Multnomah County Public Health: 503.988.3406
• Washington County Public Health: 503.846.3594
• Clackamas County Public Health: 503.655.8411
• Yamhill County Public Health: 503.434.7525

This blog is not a substitute for medical advice. Be sure to talk to your child’s medical provider with any questions.

We are excited to share that starting January 1st, 2019, Sunset is launching our Credit Card on File program!

What does this mean for my family?

• When you come in for your child’s visit, we will ask you to provide a credit or debit card number to keep on file for your child’s account.
• After your child’s visit, we will bill your insurance.
• Once your insurance company processes the claim, they will send you an Explanation of Benefits (EOB) notifying you of your share of the financial responsibility.
• After you have received your EOB, your insurance company sends Sunset that information and we process their payment.
• On Tuesdays, the remaining balance owed by you will be charged to your credit/debit card on file and you will be emailed a receipt.

Important things to know

• While most balances fall below this amount, the maximum amount your card will ever be charged at one time is $250.
• If your balance is larger than that, a member of our billing staff will contact you to arrange payment.
• Most insurance companies cover well child checks at no cost to you. It is important for you to know your insurance benefits as it relates to well child and sick visits. Contact your insurance directly for this information.
• If you wish to make a payment arrangement, you must contact our office as soon as you receive your EOB and we will be happy to set up a payment plan.
• Starting June 1^st, 2019, having a credit or debit card on file will be a requirement to be a patient at Sunset.

Frequently asked questions

How will I know what my portion of my child’s visit I am responsible for?

• Your insurance company is required by law to send you an Explanation of Benefits (EOB) which details how much they paid or did not pay and what portion of the visit you will be responsible for. You can call your insurance at any time to check how much of your deductible has been met. Some insurances have this information available online.

When do I give you my credit card?

• You will give us your card at the time of your visit. We will swipe your credit card with an encrypted reader that will securely upload your information to the company who processes our credit card payments.

But wait, I’m nervous about leaving my credit card information.

• We do not store your sensitive credit card information in our office. Once the card is swiped, only the last four digits of your account number is visible to our staff. Your credit card on file is considered protected health information under HIPAA, and therefore far more secure than most retail establishments as it relates to identity theft.

I have a Health Savings Account (HSA) or a Flex Spending Account (FSA), can I leave that on file?

• Yes, you can keep your HSA or FSA on file, however, we may require an additional card to be kept on file should the funds in your account become insufficient.

Who do I call if I have any questions or concerns?

• We do all our billing in our office. Our billing specialist is in the office Monday through Thursday from 8AM to 5:30PM. Please do not hesitate to call us!

With the winter season quickly approaching, one of the most important steps we can take to avoid getting sick and spreading germs to others is keeping our hands clean.

Make sure you and your kiddos wash your hands:

• Before, during and after preparing food
• Before eating food
• Before and after caring for someone who is sick
• Before and after treating a cut or wound
• After using the restroom
• After changing diapers or helping a child use the toilet
• After blowing your nose, coughing or sneezing
• After touching an animal, animal feed or animal waste
• After handling pet food or pet treats
• After touching garbage

Follow these steps for proper hand washing:

• Wet your hands with clean, running water (warm or cold), turn off the tap and apply soap.
• Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
• Scrub your hands for at least 20 seconds. Hum the “Happy Birthday” song from beginning to end twice for a fun way to time yourself!
• Rinse your hands well under clean, running water.
• Dry your hands using a clean towel or air dry them.

If you don’t have soap and running water, alcohol-based hand sanitizers can help in most situations. Sanitizers can reduce the number of germs in some situations, but sanitizers do not get rid of all types of germs and might not remove harmful chemicals.

This blog is not a substitute for medical advice. Be sure to talk to your child’s medical provider with any questions.

Motor vehicle crashes are the leading cause of death for children 4 years and older. The American Academy of Pediatrics (AAP) recently updated their guidance on rear-facing car seats. Previously, the AAP specified children should remain rear-facing at least to the age of 2. The new recommendation removes the specific age milestone.

• All infants and toddlers should ride in a rear-facing car seat as long as possible, until they reach the highest weight or height allowed by their car seat’s manufacturer. 
• All children who have outgrown the rear-facing weight or height limit should use a forward-facing car seat with a harness for as long as possible, again, up to the highest weight or height allowed by their car seat’s manufacturer.
• All children whose weight or height is above the forward-facing limit for their car seat should use a booster seat until the vehicle lap and shoulder seat belt fits properly. This is usually when they have reached 4 ft 9 inches in height and are between 8 and 12 years of age.
• When children are old enough and large enough to use the vehicle seat belt alone, they should always use lap and shoulder seat belts.
• All children younger than 13 years should be seated in the rear seats of vehicles.

When a child rides in a car in the rear-facing seat, the head, neck and back are all supported by the hard shell of the car seat. In the event of a crash, the car seat absorbs most of the shock and protects the most vulnerable parts of the body. When a child rides forward-facing, their bodies are only restrained by the harness straps. For toddlers, whose heads are large and heavy compared to the rest of their bodies, this can mean possible back and head injuries as the head is thrown forward in a crash.

Using the right car seat or booster for every trip lowers the risk of death or injury by more than 70 percent!

Read more on the AAP website here.

This blog is not a substitute for medical advice. Be sure to talk to your child’s medical provider with any questions.