LIHUE — The state Department of Health is encouraging everyone in Hawaii to check their medical records and get vaccinated for measles if they’re not already.
That’s in response to people with the contagious viral illness who traveled to Hawaii Island and central Oregon after being exposed to an ongoing outbreak in the Pacific Northwest.
Health officials in Oregon’s Deschutes County also issued an alert, although no cases were confirmed in either location.
Hawaii DOH says they’re not disclosing the exact location of the family with the measles that traveled to the state, but “the family self-quarantined to the home where they were staying which was located in a relatively rural area where the houses have quite a bit of land around them,” according to Janice Okubo, spokeswoman for DOH.
DOH points out the people most at risk for catching measles are those who aren’t vaccinated and that the risk of complications from measles is highest in children who are less than a year old, pregnant women, and people who have a weakened immune system.
“The best way to prevent measles is to get vaccinated. DOH encourages everyone to check their records and contact their healthcare provider if they need to be immunized. People who suspect they have measles should call their healthcare provider right away and isolate themselves from others to help contain the spread of illness,” Okubo said.
Symptoms of the measles usually start around 14 days after exposure with a range of 7–21 days, and may include high fever; cough; runny nose; red, watery eyes and a rash. Possible serious complications of measles include pneumonia, inflammation of the brain (encephalitis), and death.
“At this time, no other suspected cases have been detected in Hawaii,” Okubo said Wednesday.
There are 40 confirmed cases in the Northwest, including 38 clustered in southwest Washington, one in Portland and one in Seattle. Thirteen additional suspected cases were reported Wednesday, and some of those will likely be confirmed, according to to Dr. Alan Melnick, public health director for Clark County, in southern Washington, which is at the epicenter of the outbreak.
Officials haven’t yet determined how the measles outbreak started. The first patient sought medical care on Dec. 31, but other sick people may not have gone to a doctor or hospital, Melnick said.
Clark County, where the first case was documented, has a 78 percent vaccination rate — far below the 95 percent required for “herd immunity” for such a contagious virus.
Herd immunity, or community immunity, is when enough of the population is vaccinated to protect those who haven’t been vaccinated for medical reasons or because they are too young.
“If you have a large unvaccinated population and you add measles to the mix, one measles case will infect 90 percent of contacts, and the early symptoms are not distinguishable from other respiratory illnesses — and you’re contagious at that point,” Melnick said.
“So it’s like taking a lighted match and throwing it into a bucket of gasoline, basically,” he said.
Washington Gov. Jay Inslee last week declared a state of emergency because of the outbreak, and the federal Centers for Disease Control and Prevention has been consulting with local and state officials.
Two children who traveled to Hawaii were not contagious when they flew, Melnick said, and they were quarantined in the islands once they arrived. They have since returned home.
Of the confirmed cases, most patients were under 10 and at least 34 patients were not immunized. One dose of the measles vaccine gives 93 percent lifelong immunity; a second dose between ages 4 and 6 provides 97 percent immunity.
The vaccine has been part of routine childhood shots for decades, and measles was declared eliminated in the U.S. in 2000. But it is still a big problem in other parts of the world, and travelers infected abroad can bring the virus back and spread it, causing periodic outbreaks.
Last year, there were 17 outbreaks and about 350 cases of measles in the United States.
Before mass vaccination, 400 to 500 people in the U.S. died of the measles every year, 50,000 people were hospitalized and 4,000 people developed brain swelling that can cause deafness, Melnick said. One to three cases out of every 1,000 are fatal, he said.
People who think they may have the measles should call their health care provider before showing up so the facility can take steps to limit other people’s exposure.
Early symptoms include a fever, runny nose and malaise, followed by a red rash that starts around the head and moves down the body.