Measles case in a King County resident associated with international travel

Actions requested

• Be aware of a confirmed measles case in a King County child who traveled internationally.  
• Secondary cases, including from possible public exposures, could occur between June 12-July 4, 2024.
• 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.
• 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.
• 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).
• 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.
• Vaccinate
• Assess immunization status of patients at every visit and strongly recommend vaccination based on recommended schedule, health condition, occupation, and other risk factors such as travel.
• Under-vaccinated individuals may be at risk for measles infection due to outbreaks that occur in the US or anywhere else in the world.
• Ask patients about upcoming international travel and recommend vaccination based on recommended schedule, and other risk factors such as travel, health condition and age.

Background

Public Health is investigating a case of measles in an unvaccinated child with exposure during international travel. The case was at the following location during their infectious period before receiving the diagnosis of measles:

Date: June 10, 2024
Time: 3:30 pm to 8:00 pm
Location: Franciscan Urgent Care- West Seattle 4755 Fauntleroy Way Southwest, Suite 110, Seattle, WA, 98116

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.