Announcement

**Shiloh** · April 20, 2009, 05:09 PM

Re: Measles in VA, MD and Washington, D.C.

Source: http://www.washingtonpost.com/wp-dyn...042002556.html

Steps Retraced After D.C. Man Diagnosed With Measles

By Jenna Johnson
Washington Post Staff Writer
Monday, April 20, 2009; 5:29 PM

Health officials said today that a D.C. man was diagnosed with measles late last week, prompting authorities to retrace the his steps throughout the area to identify anyone else who may have exposed to the highly infectious disease and prevent it from spreading further.

This is the fifth case of measles in the region this year, but it is not related to the other cases. Still, the rare outbreak has prompted health officials in the District, Virginia and Maryland to focus on the small pockets of unimmunized individuals: Mostly, babies who have not yet been vaccinated and people who were born outside the U.S.

The District man contracted the virus during a three-week trip to India but did not show symptoms until after he returned home, said D.C. Department of Health Director Pierre Vigilance. Doctors believe the man's wife also has measles but they are still awaiting test results. Vigilance said the man had never been immunized, but wouldn't comment on his citizenship or why he had not been immunized.

"The reasons don't matter to us," Vigilance said at a news conference this afternoon. "We just want to contain this."

By the time the man realized he had measles and sought medical attention, he had already visited eight places in the District, Northern Virginia and Montgomery County. County health officials have released a list of those places and urge any unimmunized people who visited those locations during a given time frame to contact their local health department. [See below.]

Usually the virus causes a red skin rash, high fevers and watery eyes, and lasts for about a week. It can take as long as 21 days after exposure for the first symptoms to appear. While most people recover within a week, measles can lead to pneumonia and, in rare cases, can be fatal. Anyone who thinks they might have measles is encouraged to call ahead before arriving at a doctors office or hospital to avoid spreading the virus to other patients.

Measles cases have nearly disappeared in the United States because a vaccination is required of all children attending public schools or foreign-born individuals who become U.S. citizens. Often measles outbreaks begin when an unimmunized person visits another country where measles is still prevalent and then returns to the U.S. The virus is most commonly spread through sneezing and coughing, and can remain in the air or on surfaces for two hours.

The other four measles cases were in Montgomery County. In February, a man contracted measles while traveling abroad and then infected a co-worker. That employee then went to Shady Grove Adventist Hospital in March, where he infected an 8-month old baby.

A fourth man was diagnosed with measles earlier this month, but his case is not related to the earlier ones. Officials have contacted people he may have come into contact with at Shady Grove's emergency room on the evenings of April 5 and 6, and the hospital's short-stay unit during most of the day April 7. They also contacted members of the man's church. So far, no additional cases have surfaced but people could still show signs as late as April 29, said Ulder Tillman, Montgomery County's health officer.

Given the nature of the outbreaks, Fran Phillips, Maryland's deputy secretary for public health services, said officials are looking into using a portion of the $3.8 million in stimulus money the state received for immunization programs to target adults.

"One of the difficulties we have is adults who were born in countries without an immunization mandate who can infect people who have not been immunized before,'' she said. "We are discovering that with international travel and with foreign born people living in Maryland there are communities of unimmunized people living in our midst.''

Here is a list of times and places where there was exposure to measles. Anyone who thinks they were exposed to the virus and has not been immunized or already had measles, should contact authorities at the following numbers:

Page 2 of 2

In Arlington County, call (800) 533-4148; Montgomery County, (240) 777-4200; D.C., 311 or (202) 737-4404.

Saturday, April 4

* Used book fair at Stone Ridge School in Bethesda, 10 a.m. to 2 p.m.

* Vegetable Garden restaurant on Rockville Pike in Rockville, 12 to 3 p.m.

* Jiffy Lube on Nicholson Lane in Rockville, 1 to 3:30 p.m.

* Potbelly restaurant on 3rd Street SW near the Federal Center Metro station, 3:30 to 7 p.m.

Sunday, April 5

* Saigon Saigon restaurant in Pentagon Row in Arlington, 7 p.m. to 11 p.m.

* Harris Teeter grocery store in Pentagon Row in Arlington, 9 p.m. to 11:30 p.m

Wednesday, April 8

* Safeway grocery store on M Street SW, 4 to 6:30 p.m.

Friday, April 10

* Safeway grocery store on M Street SW, 3 p.m. to 5:30 p.m.

Staff writer Lori Aratani contributed to this report.

**Shiloh** · April 21, 2009, 05:37 PM

Re: Measles in VA, MD and Washington, D.C.

Source: http://www.washingtonpost.com/wp-dyn...042103045.html

Measles Case Reported in Prince William County
By Tara Bahrampour
Washington Post Staff Writer
Tuesday, April 21, 2009; 6:12 PM

A sixth case of measles has been reported in the Washington area, this time in Prince William County, the first sign of the disease in Virginia this year.

The Virginia Department of Health announced the case yesterday, a day after D.C. officials reported finding the highly infectious disease in a District man who contracted it during a recent three-week trip to India. There is no known link between the Virginia case and the other cases in the metro area, health officials said. The source of the measles virus in the Virginia resident has not been identified.

Denise Sockwell, the Virginia Department of Health's regional epidemiologist for Northern Virginia, said the man "did not have a history of travel outside the United States."

The Prince William County resident works at the Harris Teeter in Tysons Corner, said Jennifer Thompson, director of communications for the supermarket chain.

"The person is fine now," Thompson said, adding that the store sent voice mail messages yesterday to 1,074 customers who had shopped there during the man's shifts April 10-14, alerting them to possible exposure. She said no other employees had contracted the disease and the man has not yet returned to work.

The man also visited several other places where unimmunized people might have been exposed, including a Safeway and 7-Eleven in Woodbridge, an IHOP in Falls Church, and a CVS in Fairfax Station. People who think they might have contracted measles should contact their doctor's offices before going in to see them, Sockwell said, so that precautions can be taken to prevent others from being exposed.

Measles germs can linger in the air for up to two hours, putting at risk people who have not been vaccinated. In the United States, that includes babies under 1 year old who are too young for the vaccine, people who have moved here from countries where the vaccine is not prevalent, and people who decide against getting it for religious or other reasons.

People born before 1957, when the vaccine was not available, are generally considered to be immune because they are assumed to have contracted the disease as children, health officials said. "In those days it was thought of as a disease of childhood," Sockwell said. According to the 2007 Virginia Immunization Survey, 94 percent of kindergarteners and 98 percent of sixth-graders in Virginia are vaccinated, she said.

The virus spreads through coughing and sneezing, and while most people recover fully, it can lead to complications such as ear infections, pneumonia and even death. Symptoms include a rash, high fever, cough, runny nose, and red, watery eyes, which can start 7 to 21 days after exposure and last about a week.

Six cases in a metropolitan area in a short period of time is rare, Sockwell said, noting that before one reported case last year, the state had not had a case in six years.

**Shiloh** · April 21, 2009, 05:57 PM

Re: Measles in VA, MD and Washington, D.C.

Source: http://www.news8.net/news/stories/0409/615362.html

More Measles Cases, Possible Exposure Sites Confirmed
posted 04/21/09 4:43 pm

WOODBRIDGE, Va. - Area health officials reported the sixth and seventh confirmed measles cases Tuesday, including the first in Virgnia, and they also identified six additional sites at which people could have been exposed to the highly communicable virus.

D.C.'s health department confirmed Tuesday that an unidentified woman is being treated for measles. Her husband has already been treated and she had previously been suspected of infection.

The Virginia Department of Health announced a Prince William County (web | news) resident has measles, the first confirmed case in the Commonwealth this year. The case is not linked to six other infections in D.C. and Maryland, officials said. How the Virginia resident became infected also remains under investigation, officials said.

Measles is highly contagious, though nearly all Americans have been vaccinated against it. Those most at risk are immigrants, and children 1-year-old and younger.

Initial symptoms of measles include rash, high fever, cough, runny nose, and red, watery eyes, which can last about a week. The measles virus spreads through coughing, sneezing, and contact with secretions from the nose, mouth, and throat of an infected individual. The virus can live in the air for several hours after a person coughs or sneezes.

Listed below are the dates, times and locations of known exposure sites associated with this Virginia measles case. If people were at these locations on these dates and during the specified time, they may have been exposed to measles. Please call the Virginia Disease Prevention Hotline at (800) 533-4158 if you suspect you have been exposed in Virginia. Those possibly exposed in D.C. should call 311 if they are D.C. residents or (202) 737-4404 if they live outside D.C.

Prince William County

7-Eleven -- 1445 Old Bridge Road, Woodbridge

* Wednesday, April 15: 11:45 a.m. - 7:15 p.m

Safeway, 2205 Old Bridge Road, Woodbridge

* Wednesday, April 15: 7:45 a.m. - 2:15 p.m.

Fairfax County (web | news)

Harris Teeter, 8200 Crestwood Heights Drive, McLean

* Friday, April 10: 9:45 p.m. - 12 a.m.
* Saturday, April 11: 12 a.m. - 8:15 a.m.
* Sunday, April 12: 9:45 a.m. - 6:15 p.m.
* Monday, April 13: 9:45 p.m. - 12 a.m.
* Tuesday, April 14: 12 a.m. - 6:15 a.m.

IHOP, 6655 Arlington Blvd., Falls Church

* Sunday, April 12: 4:15 a.m. - 8:15 a.m.

CVS, 9009 Silverbrook Road, Fairfax Station

* Tuesday, April 14: 4:45 a.m. - 8:15 a.m.

Washington, D.C.

Ultra Bar, 911 F Street, NW

* Saturday, April 11: 11:45 p.m. - 5 a.m., Sunday, April 12

These six possible expsoure sites are in addition to seven sites identified Monday(CLICK HERE). Some people who frequent the locations are afraid of possibly contracting the virus.

"I went on the web and I checked that all out. Then I went on the hotline and then I called my doctor," said D.C. resident Gerald Miller.

"Yeah it scared me!" added D.C. resident Kianna Wilson. "I'm about to go to Safeway and get hotdogs and hamburgers and I'm kind of scared I'm going to catch the measles!"

If you believe you need to be tested, you're asked to call your doctor ahead of time, so as not to infect anyone else in the process.

**Shiloh** · April 21, 2009, 08:36 PM

Re: Measles in VA, MD and Washington, D.C.

Source: http://www.cidrap.umn.edu/cidrap/con...easles-br.html

States sound alarms over measles cases

Lisa Schnirring * Staff Writer

Apr 21, 2009 (CIDRAP News) ? Health officials in the Washington, DC, area today said they were working to identify people who may have been exposed to a patient with measles, as officials in other states, including Virginia, Iowa, and Pennsylvania, were responding to three other recent measles exposures.

The measles patient in Washington visited a handful of sites Maryland, Virginia, and the nation's capital on Apr 4 and 5, which prompted authorities in all of the jurisdictions to issue public heath alerts urging those who think they may have been exposed to call in to emergency numbers. The Washington Post reported yesterday that the man, who had not been vaccinated against measles, contracted the virus during a 3-week trip to India.

Virginia's health department announced in a press release today that it had confirmed its first measles case of the year, in a Prince William county resident with no known link to the Washington, DC, case. Virginia officials are in the process of notifying people who may have been exposed to the patient at various sites between Apr 10 and 15.

Meanwhile, the Iowa Department of Public Health (IDPH) on Apr 16 reported measles in a child from the northwestern part of the state. The department said that it and local officials were determining who may have been exposed to the disease and investigating the source of the child's infection. Health officials held a free measles vaccine clinic in Spencer, Iowa, on Apr 18 for those concerned about possible exposure to the virus, according to an Associated Press report.

One week earlier, the Pennsylvania Department of Health (PDH) reported that the source of a recent measles outbreak involving six patients in the southwestern part of the state was a traveler from India who arrived in the United States on Mar 7. In an earlier statement the PDH said the confirmed case-patients included three members of a Westmoreland County family?two children under age 5, who had not received the measles-mumps-rubella (MMR) vaccine, and their 33-year-old father, who had received only a single dose of the vaccine as a child.

Measles is a highly contagious viral disease that can infect as many as 90% of susceptible contacts, according to the US Centers for Disease Control and Prevention (CDC). Symptoms include a rash, high fever, cough, runny nose, and watery eyes. The virus spreads through coughing and sneezing, and patients can transmit the disease within 4 days before and after rash onset. Complications, ranging from diarrhea to encephalitis, occur in about 20% of patients and can be fatal.

The spate of recent measles cases raises concerns like those expressed last year, when measles cases climbed to 138, after averaging about 50 a year between 2004 and 2007, according to the April 17 issue of Morbidity and Mortality Weekly Report (MMWR). As of Apr 11, the CDC had already recorded 14 measles cases this year.

Rising measles cases herald a worrisome drop in overall US vaccination rates, the CDC said in an August 2008 MMWR update on the disease. "Measles is one of the first diseases to reappear when vaccination coverage rates fall," the agency said.

Through the end of July last year, the CDC had already recorded 131 measles cases, from 15 states and the District of Columbia. Only 17 (13%) cases were importations, coming from Europe, India, Israel, China, Pakistan, and the Philippines. However, 99 (76%) of the cases had epidemiologic or virologic links to importation. The source in 15 (11%) of the cases could not be determined.

The CDC said the number of measles cases reported through July 2008 was the highest since 1996. But the increase was not linked to more imported cases, but rather greater viral transmission after importation into the United States. The authors described a measles outbreak in Washington that had 19 linked cases and one in Illinois that had 30.

Such importation-associated cases were occurring largely among school-age children who are eligible for vaccination, but whose parents decline the vaccines for philosophical or religious reasons, the CDC said, citing a recent study that showed in increasing number of vaccine exemptions in school children. Also, the CDC added that many states exempt home-schooled children from vaccination requirements. Last year's measles outbreaks in Washington and Illinois both occurred primarily in home-schooled children.

Last year, the United Kingdom's Health Protection Agency declared that after a drop in vaccination rates, measles was endemic again, 14 years after the disease was considered eliminated.

The CDC predicted that measles importations would continue to cause outbreaks in US communities, especially ones that have large clusters of unvaccinated people.

Patricia Quinlisk, MD, MPH, medical director at IDPH, said in the press release that the measles cases serve as a reminder for parents to vaccinate their children. "All Iowans should check their child's immunization records, as well as their own to make sure their measles vaccinations are up-to-date," she said.

See also:

CDC. Notifiable diseases/deaths in selected cities weekly information. MMWR 2008 Apr 17;58(14);376-87 [Full text]

CDC. Update: measles, United States, January-July, 2008. MMWR 2008 Aug 22;57(33):893-96 [Full text]

Apr 21 Maryland Department of Health and Mental Hygiene statement

April 21 Virginia Department of Health press release

Apr 16 IDPH press release

Apr 9 PDH press release

Mar 31 PDH press release

CDC background on measles

**Thornton** · May 12, 2009, 11:14 PM

Re: Measles in VA, MD and Washington, D.C.

This sounds like it is part of the same outbreak and then after 4/24/09 I can find no other news on it.
A TV report of how a case presented to a hospital and then seen in 3 others.

Measles outbreak at Hospital

http://fr.truveo.com/measles-outbreak-expected-to-spread/id/925846307

Virginia Health department update April 24

Fairfax County Health Department | Health

http://www.fairfaxcounty.gov/hd/comdis/measles.htm

Fairfax County, Virginia - Fairfax County Health Department works to protect, promote and improve health and quality of life for all who live, work and play in our community

Note the posted threads by Shiloh on this forum on the distribution of measles outbreaks this Spring. Measles or Influenza can be complicated by pneumonia. The associated coughing can greatly spread the exposure to measles. It is unclear but assumed that measles coinfection with influenza would increase vunerablitility to complications. Given that the UK is experieincing increase in endemic measles and the air travel from the UK to USA and other parts of the world we can expect more outbreaks of measles in the days and weeks ahead. May be worthwhile to track hospitalizations for influenza in areas where measles is reported.
JT

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Measles in VA, MD and Washington, D.C.

Measles in VA, MD and Washington, D.C.

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