Published Date: 2008-02-13 23:50:00
Subject: PRO/EDR> Measles - USA (CA) ex Switzerland
Archive Number: 20080213.0579
MEASLES - USA (CALIFORNIA) EX SWITZERLAND
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International Society for Infectious Diseases
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Date: Tue 12 Feb 2008
Source: SignOnSanDiego.com [edited]
<http://www.signonsandiego.com/news/metro/20080212-9999-1m12measles.html>
San Diego County's 1st measles outbreak in 17 years may have expanded
from 4 children last week to 10 yesterday [Mon 11 Feb 2008]. The 6
new patients, including 4 infants, may have contracted the viral
disease while in the office of the doctor who treated the 1st sick
child.
The 6 cases reported yesterday [Mon 11 Feb 2008] are awaiting test
confirmation, county health officials said. As a precaution, more
than 50 children at a charter school, a swim school and a day care
center who had contact with the patients must stay home because they
are at risk of being infected. These quarantined children had not
been vaccinated because they were younger than one year -- the
minimum vaccination age -- or their parents declined inoculation for
them, said Dr. Wilma Wooten, the county's public health officer. The
6 new patients all went to the same doctor's office on the same day.
County officials didn't identify the office. They said routine
cleaning for medical settings would be enough to kill the measles
virus, which cannot live for more than 2 hours after it is expelled
by a cough or sneeze.
The latest patients include a 10-month-old infant who attends Baldwin
Academy day care center and the Murray Callan Swim School, both in
Pacific Beach. The infant was hospitalized Saturday [9 Feb 2008] and
is expected to be discharged today [12 Feb 2008]. About 16 Baldwin
students must stay home because they have not been vaccinated or lack
natural immunity from a prior measles illness. Wooten said 13 of them
are younger than 12 months, and the other 3 are of preschool age.
County health officials have not determined how many children at the
swim school may have been exposed to the measles virus. They also
didn't say whether the other 5 patients identified yesterday [11 Feb
2008] attend any schools or programs.
The outbreak began last month [January 2008] when a child contracted
measles during a family trip to Switzerland. The child returned to
San Diego and infected 2 siblings. Two of the initial 3 patients go
to the San Diego Cooperative Charter School in Linda Vista. One of
them infected a classmate, bringing the outbreak total to 4 patients
last week. Officials for the San Diego Unified School District said
the 380-student charter school has a 90 percent measles vaccination
rate, the lowest in the district. Some of the students' parents
believe vaccines contain toxic ingredients.
Measles is a highly contagious disease, especially in children, who
can become extremely sick with pneumonia and brain swelling. The
illness can be fatal. Measles complications can be "devastatingly
severe in infants," said Dr. Stuart Cohen, a pediatrician and
president-elect of the San Diego County Medical Society. "They're
hospitalized in isolation. There is no cure per se, except rest and
hydration. Nationwide, measles has become exceedingly rare in the past
15 years because vaccination has become routine. At most elementary
schools in the county, inoculation rates range from 98 percent to 99
percent. There's a kind of herd immunity," Cohen said. "Now, you've
got some parents who have decided on their own that [vaccination is]
dangerous, and now we have an outbreak."
Schools require vaccination against measles, mumps and rubella. But
state law allows parents to obtain exemptions based on medical,
religious or personal reasons. Yesterday [11 Feb 2008], Wooten renewed
a call for parents to get their children vaccinated. After the 1st
shot at 12 months, children should be inoculated again between age 4
and 6.
[Byline: Cheryl Clark]
--
Communicated by:
ProMED-mail Rapporteur Brent Barrett
[This small but significant outbreak of measles was initiated
apparently by a child who contracted measles during a visit to
Switzerland and who subsequently transmitted the infection to 2
siblings and the classmate of one. (The ages and vaccination status of
these children is not revealed). Now, an additional 6 suspected cases
of measles have been reported, 4 of whom are too young to have
received measles vaccine. All these children contracted infection
through attendance at the office of the doctor who treated the index
case. The circumstances are not explained but deserve some comment.
Confirmation of the diagnosis is awaited. Nonetheless, this incident
illustrates both the difficulty of maintaining even a highly
immunized population fully protected and the vulnerability of
pre-vaccination age children even in a health-care setting.
Hopefully, the unvaccinated infants will recover without developing
complications. - Mod.CP]
See Also
2007----
Measles, imported - USA ex Japan 20070608.1861
Measles - USA (NM) ex India (02): importations background 20070522.1633
Measles - USA (NM) ex India 20070521.1629
Measles, adult, adoption linked - USA ex China 20070228.0715
2006
----
Measles, importation related - USA: 2005 20061226.3617
Measles outbreak, office building - USA (MA)(02) 20060621.1720
Measles outbreak, office building - USA (MA) 20060524.1462
2004
----
Measles, adoptees - USA ex China (03) 20040625.1688
Measles, adoptees - USA ex China (02) 20040416.1050
Measles, adoptees - USA ex China 20040411.0985
2003
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Measles, risk of resurgence - USA 20031104.2740
Measles, imported - USA ex Philippines: alert 20030131.0271
2001
----
Measles, imported cases - Mexico ex USA (02) 20010505.0868
Measles, imported cases - Mexico ex USA 20010504.0857
.........................................cp/msp/jw
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