8/29/05 Health Advisory also in Adobe PDF format. 8/25/05 Press Release Measles fact sheet

Specific locations and times where persons may have been exposed to measles in King County are available on Public Health’s website (www.metrokc.gov/health/measles2005.htm) and our telephone hotline (206-296-4949) and will be updated as new information becomes available.  

At this time, possible measles exposure sites include:

Recognizing measles:

Measles is characterized by a prodromal illness with fever, cough, coryza, and conjunctivitis followed in 2-4 days by a maculopapular rash. The red rash usually begins on the face and spreads to the rest of the body. Koplik spots which look like grains of sand appear on the oral and/or buccal mucosa 1-2 days prior to rash onset and last a few days. The absence of Koplik spots does not rule out measles. Measles patients often feel ill enough to seek medical care BEFORE rash onset. Patients with prodromal symptoms compatible with measles who have risk factors for exposure to measles should be evaluated for possible measles. Suspect measles cases should bypass patient waiting areas and airborne isolation precautions used whenever possible. Reception staff should know how to identify and isolate patients who present with these symptoms. Complications of measles can include otitis media, bronchopneumonia, laryngotracheobronchitis, diarrhea, and encephalitis. Measles cases are contagious from 1-2 days before onset of symptoms (typically 4 days before rash onset) through 4 days after rash onset. The incubation period is approximately 10 days (14 days to rash onset; range 7-21days).

Diagnosing measles: 

If you suspect measles and/or for assistance with diagnosis, please contact Public Health promptly by calling (206) 296-4774.  We can assist with the collection of specimens and rapid testing at a Public Health laboratory.  To avoid a delay in diagnosis, please do not send specimens to a commercial lab and wait for serologic confirmation in order to report.  Control measures are most effective if we are able to contact those exposed within 72 hours of exposure.

For exposed susceptible persons:

Measles vaccine can be given within 72 hours of exposure to a person with measles to prevent disease. For high risk persons and those for whom vaccine is contraindicated, immune globulin can be given within 6 days of exposure to prevent measles.

What the public needs to do

• Find out if you are at risk for measles. Persons who either have had measles or who have been adequately immunized against measles are protected from measles infection.  A blood test can show whether you are immune to (protected against) measles. If you are immune to measles, there is nothing else you need to do at this time.
  
  
  • You are considered immune to measles if:
    • You were born before 1957: Most persons born before 1957 had measles as children.
    • If you were born on or after January 1, 1957 and have documentation of having had at least one dose of measles-containing vaccine received since 1968 and given on or after the first birthday (Measles vaccines used prior to 1968 did not always provide reliable immunity to measles).
    • A blood test for measles antibody is positive
      
      
  • If you do not have documentation of your measles vaccination history or if you have had measles, Public Health recommends a blood test to tell you if you are immune or not. Your health care professional can arrange this.
    
    
• For persons exposed to measles who have not been vaccinated and have not had measles previously OR if your blood test shows that you do not have measles immunity:
  
  
  • Check the web site above. If you were in a location where a person with measles was at the specific dates and times listed, Public Health recommends that you receive a dose of measles-mumps-rubella (MMR) vaccine: Contact your health care professional. 
    
    
  • All persons who were in one of the measles exposure locations at the specified times or who had contact with someone with measles should monitor their health for 21 days.  If fever or rash develops, call your health care provider and tell them about your symptoms and the exposure.  Stay away from other persons and from public settings until you have been evaluated by a health care professional.  Always call before arriving at a health care facility for evaluation of possible measles.
    
    
  • A minority of people who receive MMR vaccine develop fever and/or rash after immunization.  Five to 15% of people may develop fever, usually 7-12 days after vaccination and lasting 1-2 days.  Unlike people with measles who feel ill, most persons with fever after measles vaccine are otherwise well.  Rash is reported in approximately 5% of people after MMR vaccination and usually appears 7-10 days after vaccination.  People with fever and/or rash after MMR vaccination are not contagious to others.  It is still important to let your health care professional know if you develop fever and/or rash during the time you are monitoring your health after a measles exposure, even if you get vaccinated.
    
    
• When people are immunized against measles today, they are given combined measles, mumps, and rubella (MMR) vaccine. Children born since the early 1990's receive two doses of MMR. The first dose is given at 12 to 15 months of age. The second dose may be given one month after the first dose or at entry into school or child care.
  
  
• MMR vaccinations are available at most health care providers' offices and at Public Health clinics.
  
  
• Children under one year of age, pregnant women, and persons with weakened immune systems are at high risk for severe measles and complications. These people should contact their healthcare professional if they may have been exposed to measles.

For more updates and additional information including management of measles in health care facilities see our web page for healthcare professionals at: www.metrokc.gov/health/providers/epidemiology

For information about Public Health immunization clinics see: www.metrokc.gov/health/immunization/clinics.htm

For CDC Measles information see:
www.cdc.gov/nip/diseases/disease-chart-hcp.htm

*Information on What the public need to do has been revised to emphasize the need of exposed persons to determine their immune status and be vaccinated if susceptible to measles.