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January 23, 2019

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  • Be aware of a suspected measles infection in a King County male adult. The source of the patient's measles infection is unclear, although he reported travel during part of his exposure period to Vancouver, WA, where a large measles outbreak is occurring.

  • 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: exposure at a King County exposure locations, travel to Clark County, WA, or Oregon (see specific locations below), recent international travel, and, potential exposure to a confirmed measles case.

  • Instruct reception/triage staff to identify 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 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.

Public Health is are investigating a suspected measles infection in a King County male in his 50s; the patient was hospitalized but has since recovered. It is not clear where the man's infection was acquired, although he reported recent travel to Vancouver, Washington during part of this exposure period. Vancouver is in Clark County, where 23 confirmed and 2 suspected cases of measles have been identified since 1/1/2019. Additional testing to confirm the case will be done at the Washington Public Health laboratory and results are expected by the end of the week. Secondary cases resulting from this case would be expected to occur between January 16 and February 6, 2019.

Measles outbreaks continue to occur in multiple European countries with over 40,000 cases reported in the first half of 2018 alone; approximately half of the cases in the WHO Eurpoean Region have been in Ukraine. Approximately 900 cases have been reported in Israel.


King County exposure locations

Date Time Location
Jan. 9, 2019 7:00am-6:00pm Lease Crutcher Lewis Boeing 17-88 Construction Site
2400 Perimeter Rd, Auburn WA, 98001
Jan. 10, 2019 7:00am-6:00pm Lease Crutcher Lewis Boeing 17-88 Construction Site
2400 Perimeter Rd, Auburn WA, 98001
Jan. 10, 2019 6:30pm-10:30pm Mt Rainier High School vs Kentlake High School basketball game at Kentlake High School
21401 SE Falcon Way, Kent, WA 98042
Jan. 11, 2019 7:00am-2:00pm Lease Crutcher Lewis Boeing 17-88 Construction Site
2400 Perimeter Rd, Auburn WA, 98001
Jan. 12, 2019 6:30pm-10:30pm Kent Lake High School vs. Tahoma High School basketball game at Kentlake High School
21401 SE Falcon Way, Kent, WA 98042
Jan. 14, 2019 9:55am-12:45pm Valley Medical Center, Covington Urgent Care
27500 168th Pl SE, Covington, WA 98042
Jan. 16, 2019 10:00am-12:15pm Multicare Covington Hospital Emergency Dept.
17700 SE 272nd St, Covington, WA 98042