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Health district predicts more cases of measles following Spokane County's first patient since 2015

Spokesman-Review - 2/21/2024

Feb. 21—Spokane County just had its first case of measles since 2015, and the Spokane Regional Health District expects the number of cases to grow before the outbreak is over.

Extremely rare in the modern area because of widespread vaccination, health officials still take the virus seriously because of how easily it is spread and how serious it can be for young children.

"We look at a single case as being an outbreak because transmission happens so fast," said health district epidemiologist Mark Springer.

Because of a long incubation period, the disease often has time to spread before it is caught by a medical professional. In this case, an unvaccinated resident contracted the disease while traveling overseas — where it is much more common.

This individual likely was already infectious when returning to the Spokane International Airport on Feb. 12. That person continued being in public before isolating later that week.

The health district has contacted more than 20 people who had contact with the individual, mostly in the Deer Park area. Health district officials recommend those who believe they may have been in contact with the resident to review their immunization records to ensure they have been vaccinated against measles and be on the lookout for any symptoms.

"If someone can match up the dates with the time they were at the same locations, then they may have been potentially exposed," Springer said.

Look out for symptoms if have been at any of these following locations:

* The Spokane International Airport's Concourse B between 9:30 p.m.Feb. 11 and 12:30 a.m.Feb. 12

* The Deer Park Library, 208 S. Forest Ave., between 10 a.m. and 4 p.m.Feb. 12

* Rozy'z Hot Shotz drive thru in Deer Park, 617 S. Fir Ave., between 4 and 8:30 p.m. Feb . 12

* The Deer Park Taco Bell, 807 S. Main Ave., during evening hours still to be determined on Feb. 12

* Creekside Kenpo Karate in Deer Park, 3506 Eloika Road, from 5:30 to 7:30 p.m.Feb. 13

* Deer Park'sHorizon Credit Union, 900 S. Main St., from 4:30 to 7:15 p.m.Feb. 15

Measles stays airborne for approximately two hours — much longer than respiratory viruses like the flu.

The health district expects additional cases of measles to arise from the outbreak, but they will likely come from only close contacts of the infected individual.

"Other people who live in the same household and all those who have had an exposure over a long period of time, those are the kind of people we expect to develop measles first," Springer said. "We've had a lot of cooperation with the individual and their family. They have been wonderful to work with in light of the circumstances."

Nevertheless, infections can occur outside of that insular group. Symptoms may appear from the present through March 8. An area is out of a measles outbreak after 42 days without a new case.

What are measles symptoms?

Symptoms of measles will begin between seven and 21 days after exposure as a "nondescript respiratory" illness, according to Springer. This can include a cough, fever, sore throat and runny nose, as well as the development of pink eye.

The telltale sign of measles is a rash that develops two to four days after first symptoms. This rash typically starts on the head or face and will spread down the body and out into the limbs. When this rash appears, a person's fever can spike to more than 104 degrees.

While experiencing measles, there is no treatment other than rest, fluids and control of the fever. After the rash appears, fever and other symptoms will likely fade in several days. Once infected, a person likely has lifelong immunity to the disease. While unpleasant, the disease is generally well tolerated among adults but can be dangerous for young children.

Complications associated with the disease include diarrhea, ear infections, and pneumonia. Measles can also cause an inflammation of the brain leading to convulsions and can cause deafness or developmental delays in children.

All of these complications are more common in children younger than 5. Approximately one to two children die from measles complications out of every 1,000 cases.

MMR vaccine

Children and adults are protected from these complications and from contacting the disease by the MMR vaccine, which also includes protection for mumps and rubella. Before widespread use of the vaccine, measles was endemic, and it was expected for children to contract the disease at some point in their childhood.

Now, measles rates are low in the United States because children are required to receive the vaccine in most cases. Officials recommend children receive two doses of the MMR vaccine — one at 12 to 15 months of age and another between the ages of 4 and 6.

Unvaccinated adults are eligible as well unless they were born before 1957 or are currently pregnant.

"It's very effective and it provides durable, lifelong immunity," Springer said of the MMR vaccine. But in order to effectively prevent the spread of measles, at least 95% of the population needs to be vaccinated. Springer described the area's level of vaccination as "patchy" and encouraged those who are not vaccinated or have unvaccinated children to use this as a wakeup call.

"If you have been exposed and you verify you have not been immunized, take precautions," he said. "I want to encourage folks who are vaccine-hesitant or who have concerns to talk to their family doctor."

As of the 2022-2023 school year, Washington state K-12 students had a 95.3% measles vaccination rate. Spokane Public Schools had a 90.1% vaccination rate among its students. Deer Park School District, predominately where this exposure occurred, had 81.1% measles vaccination rate in its school district and 72.8% compliance among required vaccines as a whole.

Springer said the health district is not aware of any exposure within the Deer Park School District.

Washington had a widespread measles outbreak in 2019 totaling 90 cases — the most cases in a given year since 1990. The state mirrored measles outbreaks across the country that year, when 1,274 individuals contracted the disease across 31 states.

Spokane avoided any cases that year in large part because there is less international travel in Eastern Washington, Springer said.

"We have just been a little bit luckier than the West Side in the sense that we have a smaller population and that we don't have as much international travel coming through our community," he said.

Spokane last had measles in 2015, when two cases were diagnosed.

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