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HomeMy WebLinkAbout20150213_Second Measles Case Diagnosed in Clallam County (PDF)Always working for a safer and healthier community 615 Sheridan Street Port Townsend, WA 98368 www.JeffersonCountyPublicHealth.org Community Health Environmental Health Developmental Disabilities Water Quality 360-385-9400 360-385-9444 360-385-9401 (f) (f) 360-379-4487 February 13, 2015 To: Jefferson County Health Care Providers From: Tom Locke, MD, MPH, Jefferson County Health Officer Re: Second Measles Case Diagnosed in Port Angeles Situation Update: A second measles case has been confirmed in Clallam County. The patient is a 5-year old child who attends kindergarten at Olympic Christian School. The patient was present at school on February 6, 2015, a time at which she may have been infectious, exposing other children. We are working with school officials to implement exclusion procedures for all exposed students who are not fully immunized. Starting February 17 (the next day of regular classes):  Students with two MMR vaccines will be allowed to return school.  Students with one MMR vaccination will be excluded from school for 21 days since the exposure (until February 27, 2015). If they receive an additional vaccination, they will be allowed to return to school.  Students with no MMR vaccinations or an uncertain history of vaccination will not be allowed to return to school for 21 days after the exposure (February 27). These children should not be vaccinated with MMR until after February 27. All excluded students should be kept in quarantine. This quarantine is effective today, February 13, 2015. Exposed, unvaccinated children should be kept at home and should not go to any public settings. They should not have contact with susceptible children, adults, and infants. Clallam County’s second measles case has been epidemiologically linked to the first case. In addition, the child was brought to a local clinic without notification of staff, leading to multiple waiting room exposures. Active Measles Surveillance: We fully anticipate additional cases occurring in the community. Providers should remain vigilant for patients with signs and symptoms of measles (fever above 101 degrees F, prodromal symptoms, and generalized maculopapular rash) and collect appropriate specimens on suspect cases including serum for measles IgM, specimens for PCR testing and viral culture (nasopharyngeal swab, urine). Call Jefferson County Public Health (JCPH) 385-9400 to expedite testing through the State Public Health Lab. Do not use commercial laboratories. Report suspected cases of measles to JCPH immediately before discharging or transferring a patient. Always working for a safer and healthier community Community Health Environmental Health Developmental Disabilities Water Quality 360-385-9400 360-385-9444 360-385-9401 (f) (f) 360-379-4487 Infection Control: Because measles is highly contagious, instruct reception staff to identify patients presenting with symptoms of possible measles. All patients with a history of fever followed by generalized rash (usually starting on the head and neck) should be considered suspect for measles.  Promptly isolate patients with suspected measles. Patients should wear a mask covering the nose and mouth and should be kept away from other patients.  Room 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 room for 2 hours. Environmental surfaces should be cleaned with a sanitizing wipe Health care practices may wish to post signage at entry points asking patients not to enter the building and expose others if they have fever and rash. Rather, they should be asked to call for assistance so that special arrangements may be made to prevent exposure of others. Control Measures: At this time we encourage you to ensure all patients are up to date on measles, mumps, rubella (MMR) vaccine. We recommend following routine ACIP guidelines for MMR vaccination which includes administration of the first dose of MMR at 12-15 months of age. If further spread of measles is documented it may become necessary to alter the vaccination schedule at begin infant vaccination at 6 months of age. I do not recommended deviation from the ACIP vaccination schedule at this time. Other Resources: A comprehensive manual of measles control protocols is available at: www.doh.wa.gov/Portals/1/Documents/5100/420-063-Guideline-Measles.pdf Excellent materials are also available for patients and health care providers at: http://www.cdc.gov/measles/