Measles case in a visitor to King County with multiple local exposure sites
May 4, 2019
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- Be aware of a measles case in a visitor who spent time in King County during his infectious period. The source of the infection is not known but during his exposure period the case reported spending time in Japan and New York, where measles cases are occurring.
- Secondary measles cases resulting from exposure to this case would be expected to have symptom onset between April 28, 2019 and May 19, 2019.
- Consider measles infection in patients with compatible symptoms, including:
- Prodrome of fever, cough, coryza and conjunctivitis lasting 2–4 days;
- Generalized maculopapular rash that usually begins on the face;
- Koplik spots may appear on buccal mucosa 1–2 days prior to rash.
- Assess patients with measles symptoms for: presence at King County exposure locations, travel in the U.S. or internationally where measles outbreaks are occurring, and exposure to a confirmed meases case.
- Instruct reception/triage staff to identify patients who present with symptoms of possible measles at presentation
- Patients with symptoms of measles should wear a mask covering the nose and mouth and should be kept away from patient waiting rooms;
- Room the patient immediately and close the door;
- Only staff with documented immunity to measles should be allowed to enter the patient’s examination room;
- After the patient is discharged, do not use the room for 2 hours.
- Report suspected cases of measles to Public Health at (206) 296-4774 immediately and before discharging or transferring patients.
- Collect specimens on patients with suspected measles:
- Nasopharyngeal swab (preferred respiratory specimen) for PCR and virus isolation;
- Urine (at least 50 ml) for PCR and virus isolation;
- Serum (at least 1 cc) for measles IgM.
- Route laboratory specimens through Public Health to expedite testing, do not use commercial laboratory.
- Healthcare providers should ensure all children and adults are up to date on measles vaccination.
Public Health is investigating a measles infection doiagnosed in a Canadian male in his 40s; onset of rash was April 25, 2019. The patient did not require hospitalization and has since recovered. The man likely acquired the infection during international travel. Secondary cases resulting from exposure to this case would be expected to occur between April 28, 2019 and May 19, 2019.
Measles cases continue to occur in the U.S. with over 704 individual cases of measles confirmed in 22 states this year (as of 4/26/19). Measles is also occurring in multiple other countries including Canada (British Columbia), Israel, Ukraine, Japan, Brazil and Philippines.
King County exposure locations for the current case (as of 5 May 2019 - updates will be posted when available on the Public Health Insider blog.)
|Date||Time||Location||April 21, 2019||8 – 10 p.m.||Sea–Tac International Airport|
|April 24, 2019 – April 28, 2019||Starting 10 p.m. 4/24 to noon 4/28||Marriott Courtyard Hotel Pioneer Square (612 2nd Ave, Seattle 98104)|
|April 25, 2019||11 a.m. – 1 p.m.||Storyville Coffee (1001 1st Ave, Seattle 98104)|
|April 26, 2019||11 a.m. – 2 p.m.||Immediate Clinic Capitol Hill (1512 Broadway, Seattle 98122)|
|April 26, 2019||12 p.m. – 2 p.m.||Monorail (Westlake Station to Seattle Center)|
|April 26, 2019||2:30 p.m. – 6 p.m.||Seattle Space Needle (400 Broad St, Seattle 98109)|
|April 27, 2019||morning||Slate Coffee Roasters (602 2nd Ave, Seattle 98104)|
|April 27, 2019||11 a.m. – 3 p.m.||MoPOP - Museum of Pop Culture (325 5th Ave, Seattle 98109)|
|April 27, 2019||1:30 – 3:30 p.m.||Market Fresh (720 Olive Way, Seattle 98101)|
|April 27, 2019||9:30 p.m. – 2 a.m.||The Pink Door (1919 Post Alley, Seattle 98101)|
|April 28, 2019||morning||Slate Coffee Roasters (602 2nd Ave, Seattle 98104)|
|April 28, 2019||10 a.m. – 1:30 p.m.||Kenmore Air Flight M5 340|