Health Advisory: Measles Cluster in Southwest Washington
January 11, 2024
Action Requested
- Be aware that multiple cases of measles have been confirmed among unvaccinated adults in Clark in Wahkiakum counties. As of January 10, 2024, three lab-confirmed cases had been identified as well as three epi-linked cases. There are no known public exposures and investigation is ongoing.
- Please consider measles in patients who:
- Present with febrile rash illness and cough, coryza (runny nose) or conjunctivitis (pink eye)
- Recently traveled internationally or were exposed to someone with confirmed measles
- Review and consider using a measles assessment checklist like this one provided by the Washington State Department of Health.
- Report any suspected cases of measles in Snohomish County to the Snohomish County Health Department within 24 hours.
- Call 425-339-3503 to reach the Communicable Disease program by phone.
- Please complete and fax the Communicable Disease Report Form (PDF) and any accompanying lab reports to 425-339-8706.
- 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 U.S. or anywhere else in the world.
- Be prepared for the possibility of patients with measles at your facility:
- Suspected patients should wear a mask covering the nose and mouth
- In urgent/emergency healthcare settings:
- Suspected patients should be triaged immediately away from waiting rooms
- Room patient in airborne isolation if available
- In outpatient clinic settings:
- Schedule suspected patients to be seen at end of day, if possible, and keep them out of waiting rooms
- Use standard and airborne infection control precautions
- Only staff with documented immunity to measles should enter patient’s room.
- After patient is discharged, do not use or have staff enter the room for 2 hours.
- Collect specimens on patients with suspected measles for diagnostic testing:
- For PCR and virus isolation:
- Nasopharyngeal swab placed in viral transport media (VTM)
- Urine, minimum 20mL, in sterile leak proof container
- For measles IgM serology:
- Serum, minimum 1mL, in red top or red-grey top tube
- For PCR and virus isolation:
- Route specimens through Public Health to expedite testing (do not use commercial laboratory).
Background
Clark County Public Health, Wahkiakum County Health and Human Services, and the Washington State Department of Health have identified a cluster of lab-confirmed cases cases of measles in unvaccinated Clark and Wahkiakum County residents. The Region 4 Provider Advisory available here includes additional details. There are no known public exposures; the cases began isolation upon recognition of initial measles-like symptoms. Symptom onset dates for cases were in mid- to late-December. The investigation is ongoing.