Health AdvisoryMeasles

Measles Provider Alert May 2019

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Provider Alert

For immediate release: May 15, 2019

Dear Colleagues,

A Pierce County man in his 40’s has been diagnosed with measles. The Tacoma-Pierce County Health Department and Public Health-Seattle & King County are investigating this jointly as he spent a significant amount of time at the Sea-Tac Airport. It is unclear where this patient was exposed to the virus. The onset of his rash was May 10/11, so he was exposed sometime between April 19th and May 1st. Subsequently, this patient spent time working at Sea-Tac during the infectious period. Exposures in the community as a result of this case occurred between May 6th and May 11th. We would expect cases from these exposures to occur between May 13th and June 1st, 2019. As much of his exposure period was at Sea-Tac airport, many of the exposed may have returned to your counties after air travel. Please advise your providers to be on alert for cases of measles that may have had the following exposures:

Pierce and King County locations of potential exposure to measles

May 6 – 10, 2019 – 5:30 – 8 a.m. Sea–Tac International Airport Main parking garage 8th floor, far southern garage elevator, 4th level breezeway to escalator, terminal to baggage claim area
May 6 – 10, 2019- 2 – 5 p.m. Sea–Tac International Airport Baggage claim area to escalator, 4th level breezeway, far southern garage elevator, 8th floor parking garage
May 6, 2019- 5 – 7:15 p.m. Orting Transmission 130 Corrin Ct. NW., Orting
May 6, 2019- 6 – 10 p.m. Orting High School, Orting City Planning Meeting, 320 Washington Ave. N. Orting
May 7, 2019- 10 a.m. – 12:15 p.m. Sea–Tac International Airport General area around gate A10 of Sea–Tac Airport
May 7, 2019- 5 – 8 p.m. Orting Transmission 130 Corrin Ct. NW., Orting
May 7, 2019- 7:30 – 10 p.m. Orting High School, Orting Junior Dance Team Banquet, 320 Washington Ave. N. Orting
May 9, 2019- 10 a.m. – 12:15 p.m. Sea–Tac International Airport General area around gate A10 of Sea–Tac Airport
May 9, 2019- 4 – 7:30 p.m. Discount Tire, 19815 S. Prairie Rd. E., Bonney Lake.
May 9, 2019- 6 – 9:30 p.m. Skookum Archery, 11209 Shaw Rd. E., Puyallup.
May 10, 2019- 6:30 – 8:40 a.m. 76 Gas Station Market, 2841 S 188th St, SeaTac
May 10, 2019- 3:15 – 5:45 p.m. and 6:30 – 9 p.m. Orting Transmission 130 Corrin Ct. NW., Orting
May 11, 2019- 8 – 10:30 a.m. Sound Family Medicine Bonney Lake Walk–in Clinic, 10004 204 Ave., Bonney Lake.

ADVICE

1. 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.
• Koplik spots may appear on buccal mucosa 1–2 days prior to rash.

2. Assess patients with measles symptoms for local exposures (listed above), domestic or international travel to areas where measles outbreaks are occurring, or potential exposure to a confirmed measles case.

3. Instruct reception/triage staff to identify and isolate 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.

4. 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 cc) for measles IgM.

5. Call the Yakima Health District with any suspected measles case so that we may expedite lab testing and begin necessary public health investigation. Report suspect cases to Disease Control at (509)249-6541. Measles is a notifiable condition in Washington State: https://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/NotifiableConditions/ListofNotifiableConditions