By John Fraser

I sat down recently with Nurse Amanda, an itinerant public health nurse from the Alaska Department of Health who supports the Seward, Moose Pass, and Hope areas. Based in Kenai, Amanda travels to our community once or twice each month to provide essential health services and updates.

For those who haven’t met her, Nurse Amanda is approachable and calm — even when discussing public health concerns that should raise our eyebrows.

“I’m in Seward one to two times a month,” she explained. “I offer immunizations, STI screenings, and birth control. I can also talk about other health concerns, though I can’t provide full treatment or medical advice beyond those core services.”

– Nurse Amanda

Nurse Amanda said that her days in Seward can vary, but she lets people know her schedule in advance, and posts flyers at places like the library, post office, the Community Health Center, the Seward Chamber of Commerce site and on Facebook.

Two of the most serious things she’s watching out for this summer are emerging cases of measles and whooping cough. Measles spreads easily — more than almost any other disease. People can pass it on up to four days before they even see a rash on their skin.

Measles is back

Measles was once considered under control in the U.S., thanks to vaccines introduced in the late 1950s and refined in the 1960s. Most adults under 65 were vaccinated, and outbreaks became rare and seemed to be in the distant past. These vaccines were tested and tested for efficacy. But as fewer people are being vaccinated and many are unfamiliar with how dangerous measles can be — the risk is returning.

Nurse Amanda knew of 935 measles cases across the U.S. when we met on May 7 for this interview, but by May 8, the Centers for Disease Control updated that number to 1,000, and is now reported to be 1024 reported in 31 states including Alaska as this article went to press, The more concerning statistic is that 38% are infections month 5 – 19 year olds and 32% are in adults.  96% of all cases are unvaccinated people and hospitalization rate remains at 13%.  An outbreak is defined as more than 3 cases in one area because the disease is so highly contagious that over 3 quickly multiples into a very large number. 

Measles is one of the most contagious diseases. It can spread up to four days before symptoms like a rash appear. It often starts with a cough, runny nose, and red or watery eyes. Patients can also have a high fever. A few days later, a rash appears.  

While many people still think of it as a childhood disease, Amanda says the most at-risk ages are unvaccinated children under 5 and unvaccinated adults over 20, especially those who have compromised immune systems, or unvaccinated pregnant women. Measles has a very high 13% hospitalization rate, and infection can cause pneumonia or encephalitis (swelling in the brain), which can be deadly.

She urges everyone to make sure they are vaccinated. “We know that the MMR vaccine is safe and effective,” she said. “It’s the best way to protect yourself, your family, and everyone who’s at risk in our community.” 

If someone thinks they were exposed or begins to feel sick, Nurse Amanda recommends calling the emergency room or your doctor before you go in. This helps hospitals prepare.  They have what’s needed to protect everyone from infection and can be set up to help prevent the disease spreading to others at the hospital if they know you’re coming in.

A warning about whooping cough

Another illness that’s on Nurse Amanda’s radar is pertussis, which most of us know as whooping cough. Nationally, the Center for Disease Control has reported that pertussis cases have been on the rise. In 2024, the CDC reported over 35,000 pertussis cases, a significant increase from approximately 7,000 cases in 2023, and Alaska was not spared, with the same parallel rise in cases.

Nurse Amanda described whooping cough as a “really harsh” violent coughing. She described kids coughing so hard and long that they turn blue from a lack of air or even vomit after coughing. For adults, it might just feel like a bad cough that lasts a couple of months. But in babies, it can be deadly. In the USA, the Center for Disease Control reported that by April 2025, the USA was on track to see double the number of pertussis cases in 2024, when the number of cases was considered a public health concern. Both the CDC and the Alaska Department of Health are now tracking more cases than they saw at this time in 2024. 

The good news? There are now two different reliable tetanus, diphtheria, and pertussis (Tdap) vaccines that have been around since 2005. Amanda says adults should get a booster every 10 years, especially if they work around sharp tools or rust, like in shipyards or fish processing, or just like to get out into nature, because the tetanus bacteria is found in dirt. 

An examination of the Tdap vaccine rates in the Kenai Peninsula is concerning. It appears that only about 40% of people are protected from risk in our area, despite the large number of people who enjoy outdoor activities year around. 

Data obtained from the Alaska Department of Health, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, Alaska Behavioral Risk Factor Surveillance System data, 2016 – 2024. 

The graph was created through the Alaska Behavioral Risk Factor Surveillance System, an online database maintained by the Alaska Department of Health, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion.  

Nurse Amanda said, “As long as we have dirt with us, we’re going to have tetanus. When people spend a lot of time in nature or gardening, or walking about, that’s where it can be contracted. It’s just good to be protected.”

Her best advice? “Get vaccinated, get tested, and if you’re sick, don’t ignore the signs. Call someone. We’re here to help.”

To learn more, Nurse Amanda can be reached through the Kenai Public Health Center at 907-335-3400.  Until early May, Nurse Amanda was able to meet in person with Seward residents at 302 Railway Ave, Seward, AK 99664. 

Unfortunately, just one week before this article went to press, Governor Dunleavy issued an Administrative Order that suspended funding for the traveling nurse who serves Seward. The Seward Folly contacted both the Alaska Department of Health and the Governor’s office to understand the reason for this sudden withdrawal of services, but neither provided a response before publication. At this time, it remains unclear whether the decision was made solely by the Governor or if it was prompted by changes at the federal level.

John Fraser is a psychologist, Director of Mission Impact at the Alaska SeaLife Center, a ceramics teacher at Keramiikka Ceramic Studio and Gallery, and fosters cats for the Seward Animal Shelter.