Friday, March 21, 2014

Measles Outbreak Alert: Information and Photos from the CDC

Whatcom County, located in northwestern Washington State, has just had its first case of measles since 1995. In addition, there is a measles outbreak occurring presently in British Columbia, Canada.

Given that vaccination rates are not 100%, the return of measles has triggered an aggressive public health alert in order to contain any new outbreaks that may occur.

In the pre-vaccine era, measles regularly affected a large percentage of the population in the U.S., primarily children. It killed about 1 to 3 people out of a thousand infected, and caused permanent brain damage in about 1 to 2 people out of a thousand people infected.

Measles information from the CDC

  • Measles is a highly contagious rash illness that is transmitted from person to person by direct contact with respiratory droplets or airborne spread. 
  • About 90% of susceptible exposed individuals will get infected.
  • The average incubation period for measles is 10 to 14 days from exposure to rash (range: 7–21 days).
  • Persons with measles are infectious 4 days before through 4 days after rash onset.
  • Commonly reported complications are pneumonia (6%), otitis media (7%), and diarrhea (8%)
  • In low to middle income countries where malnutrition is common, measles is often more severe and the case-fatality ratio can be as high as 25%
  • Measles can be severe and prolonged among immunocompromised persons, particularly those who have leukemias, lymphomas, or HIV infection. Among these persons, measles can occur without the typical rash and a patient can shed measles virus for several weeks after the acute illness. However, a fatal measles case without rash also has been reported in an apparently immunocompetent person.
  • A persistent measles virus infection can result in subacute sclerosing panencephalitis (SSPE), a rare and usually fatal neurologic degenerative disease.Signs and symptoms of SSPE appear an average of 7 years after measles infection, but might appear decades later.
  • Widespread use of measles vaccine has led to the virtual disappearance of SSPE in the United States, but imported cases still occur.

CDC - Measles: Photos

From the Whatcom County department of health:

Precautions To Take When Scheduling Visits for Measles Assessment
  • Instruct telephone and triage staff to assess for rash illnesses prior to the patient coming to the facility
  • Patient MUST wear a mask before they enter the facility. (surgical masks are sufficient). Examine patients in their vehicle if necessary.
  • Rapidly isolate persons with suspected measles in a private room and call the Health Department. In hospital settings, patients with suspected measles should be placed immediately in a negative-pressure isolation room if one is available and, if possible, should not be sent to other parts of the facility.
  • Only staff who have documented immunity to measles should be present in the room with the patient.
  • Airborne precautions must be implemented during the exam. (N-95 masks are preferable, when available, for staff to use while in the room).
  • The exam room should not be occupied for at least two hours after the patient leaves.
More information: