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February 22, 2022

Confirmed measles case in a Snohomish County resident with exposures in King County

Actions requested

Be aware of a confirmed measles case in an infant.The infection was likely acquired while traveling outside the United States.

  • Assess patients with measles symptoms for recent international travel, exposure at a King County exposure location (see below), or potential exposure to a confirmed measles case.
  • Consider measles infection in patients with compatible symptoms, including:
    • Prodrome of fever, cough, coryza and conjunctivitis lasting 2–4 days
    • Generalized maculopapular rash that usually begins on the face at the hairline and spreads downward to the neck, trunk, and extremities
    • Koplik spots may appear on buccal mucosa 1–2 days prior to rash
  • Instruct reception/triage staff to identify patients who present with symptoms of possible measles
    • Patients with symptoms of measles should wear a mask covering 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 immunity to measles should be allowed to enter the patient's room.
    • After the patient is discharged, do not use the room for 2 hours.
  • Report suspected cases of measles to Public Health at (206) 296-4774 immediately before discharging or transferring patients.
  • Collect specimens on patients with suspected measles:
    • Nasopharyngeal swab (preferred respiratory specimen) for PCR and virus isolation
    • Urine (at least 50 ml) for PCR and virus isolation
    • Serum (at least 1 ml) for measles IgM
  • Route laboratory specimens through Public Health at (206) 296-4774 to expedite testing, do not use a commercial laboratory.

Background

The Snohomish Health District is investigating a confirmed measles infection in a Snohmish County infant resident. The case was in King County while infectious, with possible public exposures noted below. Investigation is underway to determine potential exposures during air travel into SeaTac. Secondary infections resulting from exposure to this case are expected to occur between February 26, 2022 to March 13, 2022.

Measles outbreaks continue to occur in many areas of the world. Additional cases of measles can occur in any community when travelers who get measles abroad bring it back to the United States and when further spread in U.S. communites occurs, primarily in clusters of unvaccinated persons.

King County exposure locations:

Date Time Location
2/19/2022 11:45 a.m. – 2:24 p.m. SeaTac Airport - South Satellite (gate 16), Customs and Border Security, train to Main Terminal, baggage claim (Carousel 1)
2/20/2022 12:34 a.m. – 2:49 a.m. Seattle Children's Hospital, Emergency Room Lobby, 4800 Sand Point Way NE, Seattle
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