A child with measles, a rare but highly contagious airborne disease that carries the potential for serious health complications, was in The Dalles over the holidays, visiting a local store and a museum on Dec. 29 and Dec. 31.
The North Central Public Health District learned of the case late on Thursday, Jan. 3, and notified area health providers that same day. They announced it to the public on Friday.
Because it takes time for symptoms to appear, it is too soon to tell if another case will develop, said health district Executive Director Teri Thalhofer.
The six-month-old child was at the Discovery Center on Dec. 29 from 1:30 to 4:30 p.m., and Fred Meyer on Dec. 31 from 5 p.m. to 6 p.m.
The child was also at three locations in Hood River on Dec. 30. The child was visiting here from abroad, Thalhofer said. Immunization levels are high in the U.S., and most cases of measles occur from international travelers, she said. Union County in Oregon had a case last year, and it was also due to international travelers.
She could not recall another case of measles in Wasco County in her 18 years with the health district.
Based on the child’s travel dates and the appearance of symptoms, it is believed the child contracted measles abroad, Thalhofer said.
On Dec. 30, the child was at Doppio Café and Goodwill in Hood River from 12 to 1, and at Full Sail Brewery in Hood River the same day from 1 p.m. to 2 p.m.
The measles vaccine is not recommended for children younger than 12 months, Thalhofer said.
The measles virus is spread through the air after an infected person coughs or sneezes. The virus can linger in the air for minutes to hours after the infected person has left.
Anyone with possible exposure is asked to be aware of symptoms, which take 7-18 days to develop. The typical rash appears about two weeks after exposure, Thalhofer said.
Symptoms start with a fever, cough, runny nose and red eyes, followed by a red rash that usually begins on the face and spreads to the rest of the body.
People are contagious with measles for four days before the rash appears and up to four days after the rash appears.
About 30 percent of measles cases develop complications including ear infections, lung infection and diarrhea. Swelling of the brain is a rare but much more serious complication. In developed countries, one or two out of every 1,000 children with measles will die from the disease, Thalhofer said.
High-risk groups for exposure to measles include children under 12 months, pregnant women, and those with compromised immune systems.
If a person gets symptoms of measles, they need to not just present to ER or their doctor’s office, but need to make a plan to enter the facility another way so they don’t expose others in the waiting room to the virus, Thalhofer said.
“The child is isolated and no one else is at risk at this point,” she said. “They followed medical advice completely so there was no issue.”
The businesses where the child visited were notified and given information to pass along to their employees. It is assumed that anyone born before 1957 is immune because measles was so common before a vaccination was introduced, Thalhofer said.
The letter sent to providers said that anyone who was born after 1957 and was known to not have been immunized was to stay away from work until Jan. 22.
The letter the health department sent to local health providers was posted to social media, which dismayed Thalhofer, since it contained identifying information about the child, saying which country the child was visiting from.
Thalhofer sent a letter to providers reminding them that health information about patients was private and not to be publicly shared. “The information you learn in the course of your work as a medical provider is not public,” she said.
“This is a good reminder to people – just because you work in healthcare and come across something doesn’t mean you have the ability to share it. That’s someone’s private health information.”
The health district learned of the measles case after the child was treated at a Portland hospital after developing a rash, Thalhofer said.