Posted Feb. 22, 2024. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.
One confirmed cases of measles (rubeola) has been identified in an unvaccinated adult resident of Spokane County. The case was exposed to the measles virus while traveling outside the United States and began isolation upon recognition of initial measles-like symptoms. Symptom (rash) onset date for this case was February 15th and isolation ended on February 20th. The case was present at the following locations and dates during the infectious period:
Whenever possible, contacts of a measles case are notified of their exposure. However, in public exposure settings it is not possible to determine all who may have been exposed. If susceptible persons were exposed to this individual at the public locations identified, we would expect to see resultant cases become ill between 2/18/2024 through 3/8/2024. At this time, we are not aware of additional cases, however, we urge your office to be prepared for handling potential cases of measles. If additional exposure sites/times become known, we will list them on For Healthcare Providers | SRHD under the Advisories & Alerts section.
Measles is a viral illness consisting of fever, cough, coryza, conjunctivitis (the “three Cs”), maculopapular rash, and Koplik spots. Usually, cold symptoms and fever precede the onset of the rash by two to four days, and a measles case will often feel ill enough to seek medical care BEFORE rash onset. If a patient has presented with coryza, light sensitivity, or cough with high fever and has a possible history of having been present at one of the locations mentioned above, please consider measles a possibility and notify SRHD immediately. The red rash usually begins on the face and spreads to the rest of the body. Koplik spots appear inside the mouth on the buccal mucosa and look like grains of sand (absence of Koplik spots does not rule out measles).
Ideally, a suspect measles case should bypass other patient waiting areas. Alert your reception staff on how to identify and isolate patients who present with these symptoms. Complications of measles can include otitis media, bronchopneumonia, laryngotracheobronchitis, diarrhea, and encephalitis.
Measles primarily spreads through large droplets but can also be transmitted through the airborne route. The virus can be transmitted through the latter route up to two hours after a contagious patient coughed or sneezed, according to the Centers for Disease Control and Prevention (CDC).
Preventing healthcare exposures is critical to keep high risk groups safe.
Please implement interventions listed below in your clinical settings to minimize exposure to others.
To potentially provide protection or modify the clinical course of disease among susceptible persons, either administer MMR vaccine within 72 hours of initial measles exposure, or immunoglobulin (IG) within six days of exposure. Do not administer MMR vaccine and IG simultaneously, as this practice invalidates the vaccine.
Individuals who should receive immunoglobulin (IG) due to severe disease and complications include:
Measles, mumps, rubella (MMR) vaccine is a two-dose series routinely recommended for children to be administered at 12-15 months of age and 4-6 years of age.
MMR vaccination is also recommended for adults if born in 1957 or later.
Current coverage rates in Spokane County are below the recommended herd immunity threshold of 92-94%. According to the Washington State Immunization Information System (WA IIS), as of January 10, 2024:
Reminder/Recall is a strategy used to identify patients who are due or overdue for vaccines. This strategy helps keep your patients up to date with recommended vaccines and can help mitigate the impact of community outbreaks. Spokane Regional Health District is recommending that all providers utilize this strategy to reach out to patients who are not up to date with their MMR vaccines.
Many electronic medical record (EMR) systems can generate a report of patients who are due or overdue for vaccinations. If your EMR doesn’t have this ability, you can utilize the WA IIS to perform a reminder/recall. Washington Department of Health (DOH) has a reference guide available on how to run this report.
DOH has created a web-based application for the public to access their immunization records in the Washington immunization registry. Recommend patients access this site as a strategy to reduce the number of requests for immunization records. Patients can sign-up for MyIR Mobile at myirmobile.com to view immunization records for themselves and their family members.
