The measles outbreak in Clark County that has racked up 23 confirmed cases since Jan. 1 isn’t likely to go away or slow down any time soon, even though no new cases or exposure locations were confirmed Wednesday.
There are seven suspected measles cases, according to a Clark County Public Health news release. One new suspected case has been reported in King County.
At Wednesday morning’s Clark County Board of Health meeting, Clark County Public Health Officer Dr. Alan Melnick warned the Clark County Council that the measles outbreak could last months, spread into other Washington counties, south to Oregon and possibly cost Clark County hundreds of thousands of dollars.
Melnick said the first several days of the outbreak response effort cost somewhere around $31,000.
“This is going to be likely hundreds of thousands of dollars if not more,” Melnick told the council. “This is going to be pretty expensive.”
Measles exposure sites
Clark County Public Health released the following list of locations where people may have been exposed to measles in the Portland-Vancouver area:
Health care facilities:
• The Vancouver Clinic Salmon Creek, 2525 N.E. 139th St., Vancouver.
4:30 to 9:30 p.m. Jan. 23.
8:15 a.m. to noon Jan. 18
• Gresham Troutdale Family Medical Center, 1700 S.W. 257th Drive in Troutdale, Ore., from 12:30 to 2 p.m. Jan. 23.
• Legacy-GoHealth Urgent Care Cascade Park, 305 S.E. Chkalov Drive, Vancouver, from 6:25 to 10:15 p.m. Jan. 22.
• Legacy-GoHealth, 22262 N.E. Glisan St., in Gresham, Ore., from 9 to 11:30 a.m. Jan. 20.
• Memorial Urgent Care, 3400 Main St., Vancouver, from 4:30 to 7:50 p.m. Saturday, Jan. 19.
• Kaiser Cascade Park, 12607 S.E. Mill Plain Blvd., Vancouver.
12:30 to 7:30 p.m. Jan. 19.
7 p.m. Jan. 15 to 2 a.m. Jan. 16.
1 to 8:30 p.m. Jan. 12.
• Legacy Salmon Creek Medical Center Emergency Department, 2211 N.E. 139th St., Vancouver.
11:40 p.m. Jan. 14 to 5:10 a.m. Jan 15.
5:45 p.m. Jan. 13 and 12:30 a.m. Jan. 14.
8:30 p.m. Jan. 12 to 1 a.m. Jan. 13.
• Kaiser Orchards Medical Office, 7101 N.E. 137th Ave., Vancouver,
1:55 to 6:10 p.m. Jan. 14.
1:50 to 7:30 p.m. Jan. 24
• Rose Urgent Care and Family Practice, 18 N.W. 20th Ave., Battle Ground, 3:45 to 8 p.m. Jan. 14.
• PeaceHealth Southwest Medical Center Emergency Department, 400 N.E. Mother Joseph Place, Vancouver.
12:30 to 8:30 p.m. Jan. 13.
10 p.m. Jan. 12 to 4 a.m. Jan. 13.
• The Vancouver Clinic, 700 N.E. 87th Ave., Vancouver.
9:30 a.m. to 1 p.m. Jan. 14.
4:30 to 7:30 p.m. Jan. 13.
10:45 a.m. to 1:30 p.m. Jan. 12.
3:30 to 7 p.m. Jan. 11.
• Vancouver Clinic Columbia Tech Center, 501 SE 172nd Ave., Vancouver, from 11:30 am to 4 pm Friday, Jan. 11.
• Magnolia Family Clinic, 2207 N.E. Broadway, Suite 200, Portland, from 11:30 a.m. to 3 p.m. Jan. 8.
Schools and child care facilities:
• Orchards Elementary School, 11405 N.E. 69th St., Vancouver, on Monday, Jan. 14.
• Evergreen High School, 14300 NE 18th St., Vancouver, on Wednesday, Jan. 9.
• Slavic Christian Academy, 7300 MacArthur Blvd., Vancouver, on Monday, Jan. 7.
• Cornerstone Christian Academy, 10818 N.E. 117th Ave., Vancouver, on Jan. 4.
• Vancouver Home Connection, 301 S. Lieser Road, Vancouver, on Jan. 7; Jan. 8; and Jan. 11.
• Hearthwood Elementary School, 801 N.E. Hearthwood Blvd., Vancouver, on Jan. 7, 9 and 11.
• Image Elementary School, 4400 N.E. 122nd Ave., Vancouver, on Jan. 8 and Jan. 9.
• Eisenhower Elementary School, 9201 N.W. Ninth Ave., Vancouver, on Jan. 8 and Jan. 9.
• Tukes Valley Primary and Middle School, 20601 N.E. 167th Ave., Battle Ground, on Jan. 8.
• Maple Grove School, 601B S.W. Eaton Blvd., Battle Ground, on Tuesday, Jan. 8 and Wednesday, Jan. 9.
• River HomeLink, 601 S.W. Eaton Blvd., Battle Ground, on Tuesday, Jan. 8 and Wednesday, Jan. 9.
• St. Paul Christian Daycare, 1309 Franklin St., Vancouver, Jan. 16, 17, 18 and 23
• Yelena’s Daycare, 17007 N.E. 23rd St., Vancouver, Jan. 22 and 23
• Dollar Tree, 11501 N.E. 76th St., Vancouver, from 8:10 to 10:50 pm Tuesday, Jan. 15.
• Dollar Tree, 7809-B Vancouver Plaza Drive, Vancouver, from 6:30 to 9:10 p.m. Jan. 15.
• Dollar Tree, 305 S.E. Chkalov Drive, Vancouver from 1:10 to 4 p.m. Jan. 21.
• GracePoint Christian Church, 7300 MacArthur Blvd., Vancouver, from 6:30 a.m. to 5:30 p.m. Monday, Jan. 7.
• Church of Christ Savior, 3612 F St., Vancouver
9:30 a.m. to noon Jan. 6
6 to 11:30 p.m. Jan. 6
9:10 a.m. to 3 p.m. Jan. 13.
• Church of Truth, 7250 N.E. 41st St., Vancouver from 11 a.m. to 4:30 p.m. Jan. 6.
• Portland International Airport, 7000 N.E. Airport Way, Portland
10:45 a.m. to 3:45 p.m. on Jan. 7. More specifically, anyone who spent time in Concourse D and the Delta Sky Lounge during that time period.
7:30 to 11 p.m. Jan. 15, baggage claim and south end of the ticket counter (near Alaska Airlines and Starbucks)
• Costco, 4849 N.E. 138th Ave., Portland
1 to 5:30 p.m. Jan. 8.
5:30 to 8:40 p.m. Jan. 16
• Amazon Lockers, 1131 S.W. Jefferson St., Portland, from 3:30 p.m. to 7 p.m. Jan. 10.
Rejuvenation, 1100 S.E. Grand Ave. Portland, from 3:30 to 7:30 p.m. Jan. 10.
Pho Green Papaya, 13215 S.E. Mill Plain Blvd., Vancouver, from 7:30 to 10:30 p.m. Jan. 10.
• Chuck’s Produce, 13215 S.E. Mill Plain Blvd., Vancouver, from 8 to 11:45 p.m. Jan. 10 and 2:30 to 5:30 p.m. Jan. 11.
• Ikea, 10280 N.E. Cascades Parkway, Portland, from 4:30 to 8:30 p.m. Jan. 11.
* Fisher Investments, 5525 N.W. Fisher Creek Drive, Camas
6:20 a.m. to 7 p.m. Jan. 10
6:20 a.m. to 7 p.m. Jan. 11
6:20 a.m. to 7 p.m. Jan. 14
6:20 a.m. to 7 p.m. Jan. 15
• Moda Center (Trail Blazers game), 1 N. Center Court St., Portland, from 5:30 to 11:30 p.m. Jan. 11.
• Verizon Wireless at Cascade Station, 10103 N.E. Cascades Parkway, Portland, from 5 to 11 p.m. Jan. 14.
• A Children’s Dentist, 101 NW 12th Ave., Battle Ground, from 1:30 to 6 pm Tuesday, Jan. 8.
• God Will Provide Church, 7321 N.E. 110th St., Vancouver, from 7 to 11 p.m. Jan. 18.
• Fred Meyer, 22855 N.E. Park Lane in Wood Village, Ore., from 11 a.m. to noon Jan. 20.
• Walgreens Pharmacy, 25699 S.E. Stark St., in Troutdale, Ore., from 1 to 2:30 p.m. Jan. 23.
• Vancouver Division of Children, Youth and Families, 907 Harney St., Vancouver, from 12:15 to 5:15 p.m. Jan. 18.
• Golden Corral, 11801 N.E. Fourth Plain Blvd., Vancouver, from 4 to 9 p.m. Jan. 19.
• Vancouver Woman, Infant and Children (WIC) office, 5411 E. Mill Plain Blvd., Vancouver, from 2:50 to 6:15 p.m. Jan. 23.
• Tower Mall public areas (entrances and hallways), 5411 E. Mill Plain Blvd., Vancouver, from 2:50 to 6:15 p.m. Jan. 23.
• New Life Mission Church, 3300 N.E. 172nd Place, Portland from 9:30 a.m. to 2 p.m. Jan. 20.
• Trader Joe's, 305 S.E. Chkalov Drive, Vancouver from 12:30 to 3:40 p.m. Jan. 21.
• Walmart Supercenter, 14505 N.E. Fourth Plain Blvd., Vancouver 1:30 to 5 p.m. Jan. 21.
A statewide emergency?
The outbreak might be declared a statewide emergency, after being declared a Clark County public health emergency by the council last week. A statewide declaration would most likely happen if the outbreak continues to increase in numbers, and reaches other counties, Melnick said.
“It’s very possible that we’ll be seeing cases outside of Clark County, including other spots in Washington as well as to our neighbors to the south,” Melnick said.
Officials are investigating a suspected measles case in King County.
Public Health Seattle & King County said Wednesday that a man in his 50s was hospitalized but has been released. Officials say the man had recently traveled to Vancouver, but it’s not clear if that’s where he might have been infected. Officials say results from additional testing to confirm the case are expected by the end of the week.
How measles spreads
It takes seven to 21 days from when someone is exposed to measles to when they develop symptoms and become contagious, Melnick said. He said the outbreak is entering its third or fourth generation, meaning the outbreak starts with a single case that then infects secondary cases, which then can infect another group as the disease starts multiplying and creating new generations.
“We’re getting into the third and fourth generation, and as you can imagine, the numbers can increase,” he told the council. “I’m hoping some of the measures we’ve taken can reduce that. But there’s a good possibility well be dealing with measles in continuing numbers and perhaps even increasing numbers in the next few weeks and months.”
A statewide emergency means that federal resources can be tapped. Melnick said Clark County Public Health is being stretched thin by the outbreak. Public Health is having to pull staff from other departments to help assist in the response.
Some food inspectors have shifted over in the response effort, which means they’re not only leaving their main duties, but also leaving a role (food inspection) that collects fees for the county.
“This basically impacts everything that we do,” Melnick said. “But we are faced with this potentially deadly outbreak here, and it’s a matter of prioritizing our resources and it’s kind of all hands on deck right now.”
Melnick says Public Health is not only fighting an outbreak, but also a campaign against false information that appears frequently online.
“Unfortunately, there’s a lot of misinformation going around on social networks, and some of it is very sophisticated looking and very well done,” Melnick said.
“In the 25 years that I’ve known about immunizations and the controversy over it, there are things on the web and there are organizations that say that vaccinations cause autism and that’s why some parents are reluctant to have their children vaccinated,” Council Chair Eileen Quiring said. She said that sometimes when people say something over and over and over again, others can perceive it as truth, even if it isn’t.
“The link between vaccination and autism has been debunked a long time ago,” Melnick said. “There’s also misinformation going on about shedding the vaccine virus and causing other people to get infected. That’s also been debunked, but it’s very believable. I think that’s difficult for parents, because they look at this stuff and it seems very legitimate. But it’s not true. That’s what we’re up against.”
Low immunization rates
Clark County has a lower immunization rate than other parts of the state and nation. Melnick says the low rates mostly stem from people requesting personal and philosophical exemptions. He said religious exemptions are rare, as are health-related exemptions.
The trend toward exemptions has slowed in recent years after new legislation required parents to meet with a medical provider to discuss vaccines and exemptions. Regardless, Melnick said Clark County’s vaccination rates are too low.
At the 11 schools for which immunization data was available, 678 of 6,958 students were listed as being exempt from receiving their measles, mumps and rubella vaccines during the 2017-2018 school year.
According to the Washington State Department of Health, Battle Ground Public School’s River HomeLink has the highest rate of students who do not have MMR shots. Of the 1,019 students enrolled at the school, 239, or 23.5 percent, are not immunized against the highly contagious virus.
Data was not available for Slavic Christian Academy, a private school located in Orchards.
Clark County Public Health is requiring exclusion of students and staff without documented immunity to measles from only schools identified as possible exposure sites. Students and staff excluded from those identified schools are also excluded from other schools, child care and other congregate settings.
Students and staff at schools where measles exposure did not occur are not impacted by exclusions.
Melnick said it would be tragic for a child to die because of the outbreak; if everyone was vaccinated, he said, measles could be eliminated. He also said that about 400 to 500 people died per year from measles before the vaccine.
Councilor Julie Olson, who represents District 2, said she wished that people would take the disease more seriously.
“This a preventable disease,” Olson said. “The idea that it is not dangerous is just wrong. That we allow our children to be exposed to this kind of illness and put them through this kind of suffering is unconscionable.”
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 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 Public Health, 503-988-3406
• Washington County Public Health, 503-846-3594
• Clackamas County Public Health, 503-655-8411
Public Health has identified additional locations where people may have been exposed to measles. There are dozens of locations in total, including hospitals, Portland International Airport and multiple schools. For a complete list of exposure sites, visit the Public Health measles investigation webpage.
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.
The Associated Press contributed to this report.