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Clark County reaches 50 measles cases; Oregon confirms three new cases

By Wyatt Stayner, Columbian staff writer
Published: February 6, 2019, 3:16pm

Clark County Public Health Director Dr. Alan Melnick again stressed proper protocol after three new measles exposure locations at medical facilities were identified Wednesday.

“If you think you might have measles, don’t just go to a health care facility. Call them first so they can see you safely,” Melnick said.

The Clark County measles outbreak has risen to 50 confirmed cases, and the Oregon Health Authority confirmed three new Multnomah County cases Wednesday, bringing that county’s total to four cases. One other case was identified in King County last month.

Public Health reported in a news release that two of the confirmed 50 patients have moved to Georgia. Three of the 11 suspected cases identified Wednesday were in people unimmunized when exposed to measles, according to the news release.

Dr. Alan Melnick, director of Clark County Public health, answers questions about the measles outbreak in Washington.

Visit this link for a list of exposure sites: www.columbian.com/news/2019/jan/29/measles-exposure-sites.

The new exposure locations are:

 The Vancouver Clinic Salmon Creek, 2525 N.E. 139th St., Vancouver, Suite 110, from 8 to 11:45 a.m. Jan. 30.

• Sea Mar Medical Clinic Salmon Creek, 14508 N.E. 20th Ave., Vancouver, 8:45 a.m. to 1:15 p.m. Feb. 1; 11:30 a.m. to 2:15 p.m. Feb. 4.

• Legacy Salmon Creek Medical Center Emergency Department, 2211 N.E. 139th St., Vancouver, from 11 a.m. to 5 p.m. Feb. 2.

Confirmed cases include 35 children ages 1 to 10; 13 youths ages 11 to 18; one adult between 19 and 29; and one adult between 30 to 39.

Of the 50 cases confirmed, 43 had not been immunized against the highly contagious virus. Immunization status could not be verified for six cases, and one case involved a child who had received only a single does of the MMR vaccine.

Matching strains

On Wednesday, Melnick confirmed the strain of the measles in Clark County matched the wild strain of the virus circulating in Eastern Europe. He stressed that this doesn’t mean the outbreak was sparked by someone from Eastern Europe.

“Somebody could have traveled there and traveled back. The virus is currently circulating in Eastern Europe, but that doesn’t mean that we don’t have that already circulating in the United States,” he said. “People keep on asking for ‘Who is patient zero,’ and ‘How did it all work out?’ The bottom line is the virus is circulating in the world. This one happens to be circulating in Eastern Europe, so it may have originated there, but it can go anywhere. As long as there’s an unvaccinated population, it doesn’t matter where it’s coming from.”

Melnick said none of the cases came from shedding of the vaccine, which is a myth that he has debunked before. He mentioned the wild strain “doesn’t really make any difference in what we’re doing.”

“There are certain minor modifications you can see with variance of the wild virus, but there’s still wild virus and the vaccine takes care of it,” he said. “The genotype we’re seeing now is one that is circulating currently in Eastern Europe. It’s preventable by the vaccine.”

Melnick also addressed online rumors that continue to circulate about immigrants bringing the disease to Clark County. He said that he hopes people will stop trying to point the finger, and mentioned that Clark County should look at itself and its low vaccination rates when trying to figure out why there’s an outbreak here.

“This bug doesn’t care about political boundaries,” Melnick said. “It doesn’t care about who you are — your race, your gender, your ethnicity. It’s only looking for an unvaccinated population to hit and the broader that population is, the more likely you are to get a widespread outbreak. That’s why the one in Clark County is so concerning because given what’s around us this could spread further. We’ve been fortunate that hasn’t happened yet, but that’s some of the stuff that keeps us up at night.”

Measles symptoms begin with a high fever, cough, runny nose and red eyes, followed by a rash that usually begins at the head and spreads to the rest of the body. A person can spread the virus before they show symptoms.

Oregon adds cases

The three new Oregon cases were in people who were in close contact with the initial Multnomah County patient, who tested positive for measles Jan. 25, and contracted measles after being in contact with a Clark County measles patient. The King County measles patient contracted the disease after traveling to Clark County.

Oregon’s new confirmed cases shouldn’t pose a threat to the public, because the people remained quarantined at home and in contact with the Multnomah County Communicable Disease Services team, according to an Oregon Health Authority news release.

“These individuals did everything right,” Dr. Jennifer Vines, Multnomah County deputy health officer, said in the news release. “They stayed away from others while on symptom watch, so we have no new public exposures to measles.”

In Oregon, the outbreak has increased vaccination numbers. The amount of measles vaccines given out in Multnomah, Clackamas and Washington counties for the last week of January was three times more than the same period last year. There were 200 vaccinations given per day last year in that last week of January, and 600 per day this year. Corresponding Clark County data was not available.

Oregon health officials still want to see more kids vaccinated. According to Multnomah County’s website, health officials sent out about 5,000 exclusion orders to families in the county to inform them their children can only remain in school if they have up-to-date immunization records, or can present an exemption by Feb. 20.

Oregon law requires children attending school, preschool and child care centers be immunized, unless they have an exemption for medical or other reasons.

What to do if you might be infected

The Centers for Disease Control and Prevention reports that 90 percent of unvaccinated people exposed to the measles virus come down with the disease. The virus lives in the nose and throat mucus of an infected person, and can survive for up to two hours in an airspace where the infected person coughed or sneezed.

Health officials are urging anyone who has been exposed at an identified location and believes they have symptoms of measles to call their health care provider prior to visiting the medical office to make a plan that avoids exposing others in the waiting room.

If you are unsure of your family’s immunization status, you can view, download and print your family’s immunization information online at wa.MyIR.net or request a copy of your immunization record from the Washington State Department of Health.

Anyone with questions about measles infection or the measles vaccine should call their primary care provider or a county health department:

Clark County Public Health, 360-397-8021.
Multnomah County, Ore., Public Health, 503-988-3406.
Washington County, Ore., Public Health, 503-846-3594.
Clackamas County, Ore., Public Health, 503-655-8411.

Clark County Public Health has been regularly updating its list of locations where people may have been exposed to measles. There are dozens of locations in total, including hospitals, Portland International Airport and multiple schools.

Public Health has established a call center for questions related to the investigation. Anyone who has questions about public exposures should call 360-397-8021. The call center is open daily.

For a complete list of exposure sites, visit the Public Health measles investigation webpage at www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Measles/MeaslesOutbreak.

Measles symptoms begin with a high fever, cough, runny nose and red eyes, followed by a rash that usually begins at the head and spreads to the rest of the body. A person can spread the virus before they show symptoms.

People are contagious with measles for up to four days before and up to four days after the rash appears. After someone is exposed to measles, illness develops in about one to three weeks.

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Columbian staff writer