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Measles case

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  7. May 20: Measles

Measles case in a King County resident with unknown exposure

Health advisory

May 20, 2023

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  • Be aware of a confirmed measles case in a King County child with unknown exposure (no international travel) and unknown vaccination history. See public exposure locations below. 
    • The infectious period for this case is May 11–May 19, 2023
    • Secondary cases resulting from this case would be expected to occur during May 18 through June 9, 2023. 
  • Assess immunization status of patients at every visit and strongly recommend vaccination based on recommended schedule, health condition, occupation, and other risk factors such as travel; Under-vaccinated individuals may be at risk for measles infection due to outbreaks that occur in the US or anywhere else in the world.   
  • Consider measles infection in exposed patients with compatible symptoms, including: 
    • Prodrome of fever, cough, coryza and conjunctivitis for 2-4 days 
    • Generalized maculopapular rash that usually begins on the face at the hairline and then spreads to the neck, trunk, and extremities
    • Koplik spots may appear on buccal mucosa 1-2 days prior to rash
  • Be prepared for the possibility of patients with measles at your facility: 
    • Suspected patients should wear a mask covering the nose and mouth
    • In urgent/emergency healthcare settings:
      • Suspected patients should be triaged immediately away from waiting rooms 
      • Room patient in airborne isolation if available 
    • In outpatient clinic settings:
      • Schedule suspected patients to be seen at end of day, if possible, and keep them out of waiting rooms
    • Use standard and airborne infection control precautions
    • Only staff with documented immunity to measles should enter patient’s room. 
    • After patient is discharged, do not use or have staff enter the room for 2 hours. 
  • Collect specimens on patients with suspected measles for diagnostic testing:
    • For PCR and virus isolation:
      • Nasopharyngeal swab placed in viral transport media (VTM)
      • Urine, minimum 20mL, in sterile leak proof container
    • For measles IgM serology:
      • Serum, minimum 1mL, in red top or red-grey top tube
  • Route specimens through Public Health to expedite testing (do not use commercial laboratory).
  • Report suspected cases of measles to Public Health at (206) 296-4774 immediately before discharging or transferring patients.

Public Health is investigating a case of measles in a King County child with unknown exposure (no international travel). The case has been hospitalized since receiving their measles diagnosis. The case was at the following public locations during their infectious period before receiving the diagnosis of measles.

DATE TIME LOCATION
5/11/23 12:00 p.m. - 5:45 p.m.

Aki Kurose Middle School
3928 S Graham Street, Seattle, WA 98118
5/12/23 8:45 a.m. - 5:45 p.m. Aki Kurose Middle School
3928 S Graham Street, Seattle, WA 98118
5/13/23 3:45 p.m. - 6:45 p.m.

Pike Place Market
85 Pike Street, Seattle, WA 98101
5/13/23 4:15 p.m. - 6:45 p.m.

World Market
2103 Western Ave, Seattle, WA 98121
5/15/23 2:00 p.m. - 5:45 p.m.

HopeCentral Pediatrics & Behavioral Health
3826 S Othello Street, Seattle, WA 98118

Up to date information about public exposure locations are online. Healthcare providers should be vigilant for potential measles infections among persons who spent time in these locations at the dates/times listed or had recent international travel. The greatest risk of measles introduction into U.S. communities is through international travel to areas where outbreaks are occurring. According to the WHO and CDC, measles outbreaks can be found in every region of the world.

People infected with measles are considered infectious from four days prior to rash onset through four days after rash (total of nine days). Healthcare facilities should screen patients for possible symptoms or exposure to measles either at triage or when scheduling appointments to identify potentially infectious cases and promptly implement recommended infection control measures to prevent transmission to other patients and staff.

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