In 2014 more cases of measles were diagnosed in the US than at any time in the past 20 years. Almost all of these cases are in people who have not been fully vaccinated and were exposed to measles while traveling outside the US, or were exposed to someone from another country who had measles. In December, a person with measles visited Disneyland in Southern California and touched off an outbreak with over 100 cases reported in 14 states. Decreasing measles vaccination rates are directly related to the spread of measles beyond just a few people who were directly exposed in Disneyland.
Immunization Rates in Portland Area
Measles, Mumps and Rubella (MMR) Vaccine Coverage
By State, Portland Area IHS and Tribal Clinics
2 year olds 1 dose MMR
13-17 year olds 2 doses MMR
Cases of measles have been reported in the Portland Area
Currently, there are five cases of measles that have been identified in Washington including two patients who visited a Tribal clinic in Clallam County, so this outbreak has now directly impacted our Tribal communities. One case has also been identified in Lane County, Oregon.
Measles Symptoms: Fever, cough, coryza (congestion or runny nose, like with a cold) and conjunctivitis (itching and redness in the eyes and/or mucus discharge, like pink-eye) are the first symptoms to appear. The rash has red or dark brown spots, usually starting on the face and spreading to the whole body beginning on the 3rd-7th day of illness.
If you think you have symptoms of measles or have been exposed to someone with measles you should call your doctor’s office or clinic right away. It is important to let them know about measles so that others in the clinic do not get exposed.
Recommendations for Control of Measles
Quarantine and Isolation
- The most effective control measure for those who have not been previously vaccinated and who cannot be vaccinated within 72 hours of exposure is quarantine from 7 days after exposure to 21 days after exposure; if symptoms develop during this time, the patient should be isolated until 4 days after the rash begins to prevent passing the disease to others.
Vaccination and Immune-Globulin
- For those who may have been exposed: Vaccination is recommended within 72 hours of exposure for those who were born after 1957 and have not been vaccinated with two doses of measles vaccine (most often as the combination vaccine of measles, mumps and rubella or “MMR”).
- Infants ages 6-11 months should receive MMR vaccination within 72 hours as outlined above if they have been exposed.
- For those who have not been vaccinated and who are past the 72 hour window to receive vaccination to prevent measles from the exposure, high dose human measles immune-globulin (IG) can be given up to 6 days after exposure. IG is most effective for children <1 year of age, pregnant women and persons who are immunocompromised (i.e., those with HIV or undergoing chemotherapy), and should be considered for unvaccinated household or other close contacts.
- Sample Press Release
- Measles Alert! flyer/sign to post on clinic, school or daycare doors (MS Publisher) (PDF)
For more information, see the following links:
- WA DOH Measles Letter for School Nurses
- Clallam County Press release: http://t.co/pizY5Aoe0Z
- Washington State DOH: http://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Measles
- Oregon Health Authority: http://public.health.oregon.gov/DiseasesConditions/CommunicableDisease/Pages/fs-measles.aspx
- CDC Measles Outbreak page: http://www.cdc.gov/measles/cases-outbreaks.html
- CDC Clinicians Update 2/19/2015: http://www.bt.cdc.gov/coca/calls/2015/callinfo_021915.asp