Background
Local public health officials in King County are investigating a confirmed measles case in a King County resident, an adult female. The individual was at Seattle-Tacoma International Airport and Providence Swedish First Hill while infectious. Anyone who was at these locations within the time span that this person passed through may have been exposed to measles. The individual was unvaccinated, and the infection was likely acquired outside the United States. Others may have been exposed in the following locations:
Sea-Tac Airport, South Satellite (Gate B6) to Baggage Claim (Carousel 04) during these times:
• January 18, 23: 12:26 p.m. – 3:00 p.m.
Providence Swedish First Hill, Emergency Department 700 Minor Ave, Seattle WA 98122 during these times:
• January 20, 2023: 2:00 p.m. – 4:55 p.m.
Illness may develop 7-21 days after exposure (through Feb 14, 2023)
If you have a suspect measles case:
- Please fill out the Measles Intake Form and notify the Whatcom County Health Department immediately. We have attached a Measles Assessment Quicksheet for your convenience.
Requested Actions
- Review the following clinical syndrome and be alert to the potential for measles. For photos of measles see: http://www.cdc.gov/measles/about/photos.html.
- A generalized rash lasting 3 or more days. (Usually begins on the face and spreads to chest and extremities.
- Immunocompromised patients may not exhibit rash or may exhibit an atypical rash.
- A temperature ≥ 101.0°F (≥ 38.3°C).
- Cough, coryza, or conjunctivitis.
- Koplik spots may appear on buccal mucosa 1–2 days prior to rash. See photo. They usually last about 12-72 hours and resolve with the onset of rash. Koplik spots are usually not present on exam.
- Check your patient’s immunization records. Following the first dose of measles vaccine, 93% of individuals respond with adequate immunity; after the second dose of MMR, 97% will respond. There are very few individuals who will not respond to MMR vaccine). Early vaccination (6-12 mo) is not recommended at this time.
- Assess the Exposure. 90% of susceptible individuals will become ill within 7-21 days (28 days if IG is administered) if they have had close contact with a measles case. (Complete intake form and send to WCHD)
- Immediately call the Whatcom County Health Department to report suspected measles cases. Call 360- 778-6100 and ask to speak to a communicable disease nurse during normal business hours, after hours follow the prompts to the answering service.
- Collect the appropriate lab specimens. See links for collection instructions from State Lab below.
- Nasopharyngeal swab (preferred respiratory specimen) for PCR and virus isolation
- Urine (at least 50 ml) for PCR and virus isolation
- Serum (at least 1 cc) for measles IgG and IgM
- Clinic instructions for staff to identify patients with symptoms of possible measles at presentation.
- Patients with symptoms of measles should wear a mask or other cover for the nose and mouth and should be kept away from patient waiting rooms.
- Room the patient immediately and close the door.
- Only staff with documented measles immunity should be allowed to enter the patient’s room.
- After the patient is discharged, do not use the room for 2 hours.
- Isolate from others until 4 days after rash onset. If prodromal symptoms are present and there is a known exposure or you suspect measles, isolate NOW. People are infectious up to 4 days before onset of rash.