Measles Causes Public Health Emergency in Washington State

Troy Brown, RN

January 23, 2019

A measles outbreak in 23 largely unvaccinated individuals in Washington state since the beginning of the year has led public health officials to declare a public health emergency, according to a January 22 statement from the Clark County, Washington, Public Health Department. The department is investigating two other "suspect cases."

Measles was confirmed in 18 children aged 1 to 10 years, four children aged 11 to 18 years, and one adult aged 19 to 29 years.

The Clark County Public Health Department statement includes a list of 36 public places where exposure to the infection may have occurred and the list is being updated regularly.

These locations include eight healthcare facilities, 12 schools, and 16 other locations including stores, churches, a Portland Trail Blazers basketball game at the Moda Center, and the Portland International Airport in Oregon — located across the Columbia River from Clark County, Washington. Numerous locations on the list had potential exposures on more than 1 day.

"Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected," according to the Centers for Disease Control and Prevention (CDC).

Twenty of the sickened individuals were unvaccinated and vaccination status is unknown for the other three. One person is reportedly hospitalized.

Portland is one of several "hotspot" metropolitan areas in the United States with high numbers of nonmedical exemptions from vaccines, according to a study published online June 12, 2018, in PLOS Medicine. Others include Seattle and Spokane in Washington; Phoenix, Arizona; Salt Lake City and Provo in Utah; Houston, Fort Worth, Plano, and Austin in Texas; Troy, Warren, and Detroit in Michigan; Kansas City, Missouri; and Pittsburgh, Pennsylvania. Additional smaller counties, particularly in Idaho, Wisconsin, and Utah, also have high exemption rates.

Call Before Seeking Medical Care, Officials Stress

Because the disease is so contagious, those who have been exposed or who believe they have the infection should call their healthcare provider before going to medical offices, urgent care centers, or emergency departments, unless they are having a medical emergency, officials say.

Calling ahead will give healthcare providers an opportunity to ensure no other patients are exposed in the waiting room.

Students and staff without documented measles immunity are being excluded from schools where exposures may have occurred; these individuals are also excluded from other schools, child care locations, and other settings where people gather. These exclusions do not apply to students and staff at schools where exposure to measles has not occurred.

The measles virus can survive for as long as 2 hours in the air where an infected individual has coughed or sneezed. Others can become infected if they "breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths," the CDC explains. Individuals with measles can spread the disease to others from 4 days before the rash appears through 4 days after it appears.

The Clark County Public Health Department will update their web page with additional information as it becomes available.

Those with questions about the investigation or about public exposures should call Public Health's call line at 360-397-8021.

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