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May 13, 2019

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  • Be aware of a new measles case in a Pierce County resident with exposures in King County (see list below, will be updated at https://publichealthinsider.com). Use these exposures when assessing persons with measles-compatible illness.

  • 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 local exposures (see list, below), domestic or international travel to areas where measles outbreaks are occurring, or potential exposure to a confirmed measles case.

  • Instruct reception/triage staff to identify and isolate patients who present with symptoms of possible measles
    • 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 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 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 acommercial laboratory.

Public Health is investigating a measles infection in a Pierce County resident who spent time in King County druing the infectious period, before being diagnosed with measles. The source of the infection for this man is unknown but was presumably acquired in Pierce County or King County, as the patient reports no travel outside the state or country during his exposure period. The patient’s onset of rash was May 10, 2019. Secondary cases resulting from this case would be expected to occur between May 13 and June 1, 2019.

Measles cases continue to occur in the U.S. with over 839 individual cases of measles confirmed in 23 states this year (as of 5/10/19) and 29 cases of measles so far this year (as of 5/6/19) among residents of British Columbia, Canada. Currently the Centers for Disease Control and Prevention has travel notices posted for the following five countries due to ongoing measles outbreaks: Israel, Ukraine, Japan, Brazil and Philippines.

Pierce and King County locations of potential exposure to measles
Date Time Location
May 6 – 10, 2019 5:30 – 8 a.m.

Sea–Tac International Airport
Main parking garage 8th floor, far southern garage elevator, 4th level breezeway to escalator, terminal to baggage claim area

May 6 – 10, 2019 2 – 5 p.m. Sea–Tac International Airport
Baggage claim area to escalator, 4th level breezeway, far southern garage elevator, 8th floor parking garage
May 6 , 2019 5 – 7:15 p.m. Orting Transmission 130 Corrin Ct. NW., Orting
May 6, 2019 6 – 10 p.m. Orting High School, Orting City Planning Meeting, 320 Washington Ave. N. Orting
May 7, 2019 10 a.m. – 12:15 p.m. Sea–Tac International Airport
General area around gate A10 of Sea–Tac Airport
May 7, 2019 5 – 8 p.m. Orting Transmission 130 Corrin Ct. NW., Orting
May 7, 2019 7:30 – 10 p.m. Orting High School, Orting Junior Dance Team Banquet, 320 Washington Ave. N. Orting
May 9, 2019 10 a.m. – 12:15 p.m.

Sea–Tac International Airport
General area around gate A10 of Sea–Tac Airport 

May 9, 2019 4 – 7:30 p.m. Discount Tire, 19815 S. Prairie Rd. E., Bonney Lake.
May 9, 2019 6 – 9:30 p.m. Skookum Archery, 11209 Shaw Rd. E., Puyallup.
May 10, 2019 6:30 – 8:40 a.m. 76 Gas Station Market, 2841 S 188th St, SeaTac
May 10, 2019 3:15 – 5:45 p.m. and 6:30 – 9 p.m. Orting Transmission 130 Corrin Ct. NW., Orting
May 11, 2019 8 – 10:30 a.m. Sound Family Medicine Bonney Lake Walk–in Clinic, 10004 204 Ave., Bonney Lake.