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July 3, 2024
Measles case associated with international travel in a King County resident
Actions requested
Be aware of a confirmed measles case in a King County resident who traveled internationally.
- Secondary cases would be expected to occur July 4, 2024 – July 23, 2024.
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Isolate
- Have a planned triage process for patients with fever and rash so these patients are not waiting in common areas with other people.
- Patients with rash and fever should not remain in waiting rooms or other common areas.
- Immediately isolate patients with suspected measles in airborne infection isolation room (AIIR) or a private room with a closed door.
- Follow standard and airborne precautions when evaluating suspected cases, regardless of vaccination status.
- After patient is discharged, do not use or have staff enter the room for 2 hours.
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Notify
- Report suspected measles cases to Public Health at 206-296-4774 immediately AND before discharging or transferring patients.
- Public Health will ensure appropriate, rapid testing and investigation.
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Test
- Collect the following specimens on patients with suspected measles:
- Nasopharyngeal swab placed in viral transport media; AND
- Urine, minimum 20mL, in sterile leak proof container; AND
- Serum, minimum 1mL, in red top or red-grey top tube
- Public Health will facilitate diagnostic testing with Washington State Public Health Laboratory (WAPHL).
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Manage
- Health care facilities should identify potentially exposed persons at the facility (patients, visitors, staff and volunteers).
- Public Health will identify close contacts and recommend post-exposure prophylaxis (PEP) for eligible people.
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Vaccinate
- Assess immunization status of patients at every visit and strongly recommend measles, mumps, and rubella (MMR) vaccination based on recommended schedule, health condition, occupation, and other risk factors such as travel.
- Ask patients about upcoming international travel and recommend MMR vaccination based on recommended schedule and vaccinate at least 2 weeks before travel. Under-immunized patients should still receive MMR vaccination if their departure is sooner.
- Under-vaccinated individuals may be at risk for measles infection due to outbreaks that occur in the US or anywhere else in the world.
Background
Public Health is investigating a case of measles in an adult with unknown vaccination history with exposure during international travel.
The person with measles was at the following locations during their infectious period (the time for exposure includes the period when the individual as at the locations listed below and two hours after, except for the first one, which was an outdoor event):
| Date | Time | Location |
|---|---|---|
| 6/27/24 | 3:30 pm to 4 pm | Vasa Park Resort 3560 W Lake Sammamish Pkwy SE, Bellevue, WA 98008 |
| 6/28/24 | 7 pm to 11:20 pm | PRO Club Bellevue 4455 148th Ave NE, Bellevue, WA 98007 |
| 6/29/24 | 6:30 pm to 9:45 pm | Café Turko 750 N 34th St, Seattle, WA 98103 |
| 7/1/24 | 7:20 pm to 9:45 pm | ZoomCare 17705 140th Ave NE, Woodinville, WA 98072 |
| 7/2/24 | 9:30 am to 2 pm | ZoomCare 17705 140th Ave NE, Woodinville, WA 98072 |
There is no ongoing risk of measles exposure at these locations.
Measles illness begins with prodrome of fever, cough, coryza and conjunctivitis (typically lasting 2-4 days) and then a generalized maculopapular rash that typically begins on the face/head then spreads to the neck, trunk and extremities. Increases in measles cases and outbreaks are occurring in every region of the world. Assess immunization status during healthcare visits and recommend vaccination based on recommended schedule, health condition, occupation, and other risk factors. CDC recommends that all U.S. residents aged 6 months and older without evidence of immunity who plan to travel internationally, receive MMR vaccine at least 2 weeks prior to departure.
Resources
➘ This page is also available in PDF format.
- For Healthcare Providers
- Increase in Global and Domestic Measles Cases and Outbreaks – CDC HAN
- Measles One-Pager for Healthcare Providers – Project Firstline and AAP
- Measles - For Healthcare Professionals– CDC
- Measles Specimen Collection Instructions for RT-PCR – WA DOH
- Immunization Schedules – CDC
- Safety Information for Measles, Mumps, Rubella (MMR) Vaccines – CDC
- For Infection Preventionists
- Interim Measles Infection Prevention Recommendations in Healthcare Settings – CDC
- Measles Playbook – APIC Emerging Infectious Diseases Task Force
- For Laboratories
- Public Health Laboratories Lab Test Menu – WA DOH
- Measles Specimen Shipping Guide – WA DOH
- For General Public and International Travelers
- Measles Resources – PHSKC
- Plan for Travel – Measles – CDC