Utah’s health care providers are being forced to adapt to America’s new reality, in which vaccine-preventable diseases become common again. Unable to contain the spread of measles—now detected in every health jurisdiction in the state—providers are trying to mitigate harm:

As officials tried to do the best they could, the outbreak spread north, hopping from one under-vaccinated community to the next. When health officials in Utah County spoke with people who had tested positive, they often had no connection to other known cases. “Pretty quickly, we started to lose the links,” said Michael Leman, the county health department’s nursing director. Contact tracing, the cornerstone of containment, was failing.

Every week, the state health department posted a growing list of locations on its website—a Trader Joe’s, a Mormon temple, an aquarium, preschools—that people had visited while contagious. But many people who tested positive hadn’t been to those places, Leman said. “They could have gotten it at Walmart. They could have gotten it walking through a mall,” he said. “I mean, just anywhere in the public they could have been exposed.”

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