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Measles outbreak in southwest Washington

Actions requested

  • Be aware of an active measles outbreak investigation being conducted by Clark and Wahkiakum Counties.
    • As of January 10, 2024, 3 lab-confirmed and 3 epi-linked measles cases have been identified among unvaccinated adults.
    • No known public exposure locations have been identified.
  • Consider measles infection in 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 possible measles cases at your facility:
    • Patients with suspected measles 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).
  • 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.
  • Report suspected cases of measles to Public Health at (206) 296-4774 immediately before discharging or transferring patients.


Clark County Public Health (CCPH), in partnership with Wahkiakum County Health and Human Services, is investigating three confirmed cases of measles among adults who are unvaccinated. Symptom onsets occurred in mid- to late-December, and all three cases report isolating at home during their contagious periods. CCPH is not aware of any public exposures for the three confirmed cases. However, in an abundance of caution, health officers are alerting providers to the presence of measles in Southwest Washington and asking providers to consider measles in patients who present with compatible symptoms.