May 31, 2024

Measles case in an adult who traveled through Seattle-Tacoma International Airport (SEA)

Actions requested

Be aware of a confirmed measles case in an adult U.S. (non-Washington state) resident exposed during international travel, who spent time at Seattle-Tacoma International Airport (SEA) while infectious.

Secondary cases would be expected to occur during May 15-June 1, 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:
- 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 are occurring 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.

CONTACT

Communicable Diseases Epidemiology and Immunization Section

401 5th Ave, Suite 1250
Seattle, WA 98104

Phone: 206-296-4774
TTY Relay: 711

Fax: 206-296-4803

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Background

Public Health was notified of measles in an adult U.S. resident with unknown vaccination history who was exposed during international travel. The case was at the following public locations during their infectious period before receiving the diagnosis of measles.

Date	Time	Location
5/10/24	Approximately 5:30 pm to 9:30 pm	Seattle-Tacoma International Airport, S Concourse (Gate S1), through Customs to International Arrivals Facility Baggage Claim (Carousel 19)
5/11/24	Approximately 7:30 am to 11:30 am	Seattle-Tacoma International Airport, A Concourse (Gate A8)

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. Ensure all patients without evidence of measles immunity are current on MMR vaccine, especially children aged >12 months and those travelling internationally. 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.