Minnesota Reports First Non-Imported Measles Case

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A case of measles has been confirmed in a 10-month-old child in Hennepin County, state health officials said today. Hennepin County Human Services and Public Health Department and the Minnesota Department of Health are collaborating in the investigation.

While the Minnesota Department of Health has had cases of measles reported to it as recently as 2007, they have been cases acquired in countries where measles is still common. This case was acquired in Minnesota, the first such case since 2001, said Ruth Lynfield, state epidemiologist at the Minnesota Department of Health. Public health professionals are investigating the source of the exposure for the case.

Cases and outbreaks of measles are currently occurring throughout the U.S., with 127 cases from January through July, the most since 1997. Many have occurred in individuals exposed to measles abroad or through someone from abroad visiting the United States. Most have occurred in unvaccinated or under-vaccinated individuals. Outbreaks of measles are currently occurring in many parts of the world including parts of Europe, where vaccination levels for measles have dropped in recent years.

In this case, the child was born in the U.S. and does not have a recent travel history. The child had not yet been vaccinated because routine measles vaccination is not recommended before 12 months of age.

“Measles is a very contagious disease that can be serious, even life-threatening, especially in young children,” Lynfield said. “The best protection against measles is vaccination.” Measles vaccination is routinely given to children at 12-15 months of age and again at 4-6 years of age.

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The child had onset of fever on July 29 and was seen in an emergency department. The child was seen again on August 2 and 3 in two different clinics. These three facilities have been notified and health officials are in the process of identifying and contacting patients and health care providers who were present at the same time as the child.

Additionally, the child was in the community while infectious. Health officials have asked doctors and health care workers to be alert for measles symptoms and possible measles cases for the next 2-3 weeks.

Measles is a serious, highly contagious respiratory illness caused by the rubeola virus. It is the most deadly of all childhood rash/fever illnesses, but is preventable with vaccine. Symptoms include fever, cough, runny nose, red eyes for a few days followed by rash. Complications from measles, which can range from an ear infection to encephalitis, are of great concern to public health practitioners. One to two children in a thousand die from the measles infection. Pregnant women who develop measles are more likely to miscarry, deliver prematurely, or have a very low birth weight baby.

Measles is transmitted by direct contact with infectious droplets or, less commonly, by airborne spread. The incubation period of measles from exposure to rash onset is generally 14 days. Patients are usually contagious from 4 days before until 4 days after the onset of the rash.

People who may be infectious should limit contact with others until a medical diagnosis has been made that excludes measles, or until 4 days have passed since the onset of the rash. They should avoid public transportation or other public indoor areas.

Patients who suspect they may have measles should call ahead before visiting a clinic or hospital. The health-care provider should provide instructions for entering the facility without exposing others in the facility.

MMR or measles vaccine administered within 72 hours of initial measles exposure may provide some protection. For some people exposed to measles, immune globulin may be given within six days of exposure to prevent or lessen infection. Immune globulin may be given to household contacts of patients with measles, particularly contacts younger than one year, pregnant women, and immunocompromised persons, for whom the risk of complications is higher.

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