Measles investigation in King County

Update on 1.23.19 at 7:30 p.m.: Laboratory tests have confirmed this as a measles case.

Original post:

Disease investigators from Public Health – Seattle & King County are investigating a suspected measles infection in a King County resident. The King County resident, a male in his 50s, was hospitalized but has since recovered. It is not clear where the man’s infection was acquired, although he reported recent travel to Vancouver, Washington during part of the time he could have been exposed. Vancouver is in Clark County, where there is a measles outbreak occurring. Additional testing to confirm the case will be done at the Washington Public Health laboratory and results are expected by the end of the week.

“Measles is a highly contagious disease and if you don’t have immunity, you can get it just by being in a room where a person with measles has been,” said Dr. Jeff Duchin, Health Officer for Public Health – Seattle & King County. “Fortunately, the measles vaccine is very effective. Two doses of measles, mumps and rubella (MMR) vaccine provides over 95% protection against measles and that protection is long lasting.”

What to do if you were in a location of potential measles exposure 

Most people in our area have immunity to the measles through vaccination, so the risk to the general public is low. However, anyone who was in the locations of potential exposure to measles around the times listed below should: 

  • Find out if they have been vaccinated for measles or have had measles previously, and
  • Call a health care provider promptly if they develop an illness with fever or illness with an unexplained rash between January 16and February 6, 2019. To avoid possibly spreading measles to other patients, do not go to a clinic or hospital without calling first to tell them you want to be evaluated for measles. 

Locations of potential exposure to measles in King County 

Transmission of measles can occur before people know they have the disease, before any rash appears. Before he was diagnosed as a suspected case of measles, the infected individual was in the following public locations. These times include the period when the person was at the location and two hours after. Measles virus can remain in the air for up to two hours after someone infectious with measles leaves the area. Anyone who was at the following locations during the times listed could have been exposed to measles: 

1/9/19, 7 am-6 pm, Lease Crutcher Lewis Boeing 17-88 Construction Site (2400 Perimeter Rd, Auburn WA, 98001)

1/10/19, 7 am-6 pm Lease Crutcher Lewis Boeing 17-88 Construction Site (2400 Perimeter Rd, Auburn WA, 98001)

1/10/19, 6:30 pm-10:30 pm, Mt Rainier High School vs Kentlake High School basketball game @ Kent Lake High School (21401 SE Falcon Way, Kent, WA 98042)

1/11/19, 7 am-2 pm, Lease Crutcher Lewis Boeing 17-88 Construction Site (2400 Perimeter Rd, Auburn WA, 98001)

1/12/19, 6:30-10:30 pm, Kent Lake High School vs. Tahoma High School basketball game @ Kent Lake High School (21401 SE Falcon Way, Kent, WA 98042)

1/14/19, 09:55 am-12:45 pm, Valley Medical Center- Covington Urgent Care (27500 168th Place SE, Covington, WA 98042)

1/16/19, 10:00 am -12:15 pm, Multicare Covington Hospital Emergency Department (17700 SE 272nd St, Covington, WA 98042)

If you were at the locations at the times listed above and are not immune to measles, the most likely time you would become sick is between January 16 and February 6, 2019.

About measles

Measles is a highly contagious and potentially severe disease that causes fever, rash, cough, and red, watery eyes. It mainly spreads through the air after a person with measles coughs or sneezes.

Measles symptoms begin seven to 21 days after exposure. Measles is contagious from approximately four days before the rash appears through four days after the rash appears. People can spread measles before they have the characteristic measles rash.

Measles complications can include ear infections, diarrhea, pneumonia, and rarely, encephalitis (brain inflammation).

Complications from measles can happen even in healthy people but those at highest risk include: infants and children under 5 years, adults over 20 years, pregnant women, and people with weakened immune systems from drugs or underlying disease.

For more information about measles and measles vaccination:kingcounty.gov/measles

Originally posted on January 23, 2019.

Posted by

I am a risk communications specialist at Public Health - Seattle & King County.

17 thoughts on “Measles investigation in King County

    1. Good enough to prove the atrocities of Unit 731, the Holocaust, the Tuskegee Syphilis Study, the Collinwood School fire, WW1, 2, Spanish-American War, Civil War etc…

  1. While the incidence of measles is being alerted in King County, such awareness should also be evoked in the school-age population. King County has an explicit policy on immunization for school entry requirement. However, the immunization rate of both kindergarten and elementary graders is inconsistent across King County (see https://www.kingcounty.gov/depts/health/communicable-diseases/immunization/child/school-immunizations.aspx). From the fluctuation between 15% to 98% of the overall immunization rate reflected on each school, the implication is that children are not only susceptible to measles, but also enhance the risk of developing other contagious disease. To protect the health of the children population, it is important to expand the awareness to all the stakeholders who work with the children population to promote the increase the immunization rate among school agers in King County.

  2. The measles vaccine should absolutely be mandatory for all schools in the US. Measles can be deadly for the very young, old, and immunocompromised. It is laughable that we as a society allow the false perception of antivaxxers to literally kill those who are unable to be vaccinated. Clearly, we are not responsible enough to handle the individual freedom of choosing to vaccinate our children and ourselves – as shown by this outbreak, pointing to low enough immunization levels. This type of absurdity has no place in modern society, and the clear benefits of vaccines for civilization cannot be crippled by the opinions of unqualified bloggers and paranoid parents.

    1. Vaccine injuries and death are real, and vaccine policy is definitely related to politics and money. Especially when vaccine manufacturers along with vaccine ingredient suppliers, vaccine vendors, or health care administrators are not liable for vaccine damage because of the National Childhood Vaccine Injury Act of 1986.

      Before diminishing the concerns of parents and fellow citizens, have a look at the facts, and see from where their certainly founded concerns derive. The following information is copied from Eric Ranger’s (2004 United States Naval Academy Graduate, Washington resident of 10 years) written testimony for HB 1638 to members of the House Committee on Health Care & Wellness. You can find the entire testimony and find numbered references at:

      https://childrenshealthdefense.org/child-health-topics/mandates/written-testimony-for-hb-1638-2019-20-madam-chair-and-members-of-the-committee/?utm_source=mailchimp

      Vaccine Injuries and Deaths
      MMR-II vaccine injuries and deaths occur in surprisingly high numbers. The National Vaccine Injury Compensation Program (VICP) has awarded about $4 billion (paid from a vaccine excise tax) in claims/petitions of the “vaccine court” since October 1988 due to injury or death arising from certain routine vaccinations recommended by the CDC.28

      As of 2/5/19, the cumulative raw count of adverse events from measles, mumps, and rubella vaccines alone, in the CDC and FDA’s Vaccine Adverse Event Reporting System (VAERS) was: 93,929 adverse events, 1,810 disabilities, 6,902 hospitalizations, and 463 deaths.30,31,32 Taking these numbers and applying a correction factor, there have likely been 469,645 adverse events, 9,050 disabilities, 34,510 hospitalizations, and 2,315 deaths related to just measles, mumps, and rubella vaccines in the U.S. The correction factor assumed that only 10% of adverse reactions are reported to VAERS, and only 50% of those reported cases are the fault of, or related to a vaccine. Both conservative estimates indeed, given that a 2007 three-year long HHS funded study by Harvard Medical School using 715,000 patients of Harvard Pilgrim Health Care found that “fewer than 1% of vaccine adverse events are reported [to VAERS].”33 A U.S. House Report similarly stated: “Former FDA Commissioner David A. Kessler has estimated that VAERS reports currently represent only a fraction of the serious adverse events.”34 It is sad that this is the best information WA parents have as part of their risk-benefit calculation with respect to vaccines and their children.

      It is interesting that 11 illnesses from Salmonella poisoning, including two hospitalizations, was enough for the FDA’s attention and The Wonderful Company’s voluntary recall of its pistachios in 2016, just two months after the first nut-related Salmonella case reported in the U.S.35 This type of quick response is standard protocol in the food industry because of food’s impact on the health and safety of the population. However, no vaccine was recalled in 2016 because of elevated adverse events reported in VAERS. Apparently, 225 vaccine-related deaths in 2016 was just business as usual–no cause for concern.36

      Merck’s MMR-II vaccine, according to its package insert:
      -does not list the number of children studied, or state the use of a randomized or other placebo control group during clinical safety trials,
      -has over 65 potential adverse reactions (nearly all symptoms or complications of natural infection from the three diseases are included), which include: **death**, brain damage, neurological damage, immune system damage, severe allergic reactions, seizures and convulsions, Guillain-Barré syndrome, sensory impairments, bowel disorders, blood disorders, and diabetes to name a few,
      -has no guarantee of performance, estimated duration of efficacy, or warranty from defect by Merck, and has not been evaluated for its carcinogenicity, mutagenicity, or ability to impair fertility by Merck.56

      Several studies show significant risks of serious conditions following the MMR-II vaccine. These studies have revealed an elevated risk of seizures, Type 1 diabetes, and thrombocytopenia (a serious autoimmune bleeding disorder) following MMR-II or MMRV vaccination.37,38,39,40,41,42 The MMR-II package insert lists all of these as potential adverse reactions to the vaccine on the manufacturer’s package insert.43

      Safety science regarding the MMR-II is surprisingly sparse. In 2011, the Health Resources and Services Administration (HRSA) contracted the Institute of Medicine (IOM) to conduct an assessment regarding vaccine safety.1 The IOM Report reviewed available science with regard to the 158 most common vaccine injuries claimed to have occurred from vaccination for varicella, hepatitis B, tetanus, measles, mumps, and rubella.2 Out of the 158 most common serious injuries reported to have been caused by the vaccines under review, the evidence supported a causal relationship for 18 of them, and rejected a causal relationship for 5 of them. For the remaining 135 vaccine-injury pairs, over 86% of those reviewed, the IOM found that the science simply had not been performed.”3 This list of vaccine-injuries includes conditions such as:
      Encephalitis, Encephalopathy, Infantile Spasms, Afebrile Seizures, Seizures, Cerebellar Ataxia, Acute Disseminated Encephalomyelitis, Transverse Myelitis, Optic Neuritis, Neuromyelitis Optica, Multiple Sclerosis, Guillain-Barre Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy, Brachial Neuritis, Amyotrophic Lateral Sclerosis, Small Fiber Neuropathy, Chronic Urticaria, Erythema Nodosum, Systemic Lupus Erythematosus, Polyarteritis Nodosa, Psoriatic Arthritis, Reactive Arthritis, Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, Arthralgia, Autoimmune Hepatitis, Stroke, Chronic Headache, Fibromyalgia, Sudden Infant Death Syndrome, Hearing Loss, Thrombocytopenia, and Immune Thrombocytopenic Purpura.4

      The lack of clear safety data on the MMR-II vaccine was summed up in an article published in Vaccine in 2003 by the Cochrane Collaboration (now known as Cochrane), one of the world’s most respected mainstream research organizations. The group examined twenty-two research studies done on the MMR-II vaccine and concluded that “the design and reporting of safety outcomes in MMR-II vaccine studies, both pre- and post-marketing, are largely inadequate.”5 I realize this statement is not saying the MMR-II vaccine is not safe. However, it is stating that the safety research could be a lot better.

      Complications of Vaccines to Very Young Children
      Children < 1-year-old could be more at risk of measles in the vaccine era. In the most recent measles outbreak in WA state, the media and many parents on Facebook have expressed frustration that babies < 1-year-old are at risk due to the outbreak. The parents often shame the parents of unvaccinated children, however, the cause of their baby’s vulnerability is mostly an effect of a universal measles vaccination program.

      In 1963, just before the measles vaccine was introduced, it was extremely rare for babies under one-year-old to develop measles since their mothers had previously contracted measles naturally, and developed protective antibodies that were passed on to their children through the placenta and breastmilk. These babies were usually protected from measles for the first 15 months of life. Vaccinated mothers provide lower titers with a shorter duration of protection than mothers who acquired the measles infection naturally. Babies born to measles-vaccinated mothers are susceptible to the disease during the crucial early months when measles can be especially dangerous.113,114

      Breastfed infants of vaccinated mothers have nearly three times the risk of measles infection than those of naturally immune mothers—even in the era of vaccination when there is supposedly less measles virus in the environment.115 Also, infants of mothers born after 1963 are 7-1/2 times more likely to contract the disease than infants of mothers born earlier. This appears to be an unfortunate, unintended consequence of the universal measles vaccination program. Age groups previously invulnerable are now susceptible to higher rates and/or more severe morbidity and mortality.116

      In 2005, nearly 60% of 503 hospitalized children with measles were younger than nine months old. Furthermore, in the 2014-2015 Disneyland measles outbreak in CA, the highest incidence per 100,000 population was among infants < 1-year-old.117 This would never have happened in 1962, before the first measles vaccines were licensed in the U.S. Let us not forget though, that thanks to their natural infections, these infants—without any vaccine—will most likely be part of the protective herd for their lifetimes.

      In the latest measles outbreak in WA state, the percentage of Clark County residents infected was about 0.01%, or 1 per 10,000 (as of 2/5/19 there were 49 measles cases in Clark County, which has a population of 474,643 as of 2017 data).83,84 As of current reporting, none of these cases have resulted in permanent injury or death. An equal threat to public health in this region is the opioid epidemic (about 18 opioid overdoses per 100,000, or about 2 per 10,000), which is inseparably tied with the immoral behaviors and greedy interests of some pharmaceutical businesses, doctors, HMOs, and regulatory agencies.85,86 Where is the Governor’s state of emergency to combat this problem? Certainly many of those overdoses could have been prevented with proper accountability measures. It flummoxes me that for one “threat” to our community, the Governor declared a statewide emergency, yet he did not for another of similar incidence with potential ripple effects of violence and crime in WA communities. Why the double standard?

      Questionable Vaccine Ingredients
      Merck’s MMR-II vaccine has questionable ingredients. For example, the MMR-II vaccine contains DNA and protein fragments from cell lines of **aborted** human fetuses (RA 27/3 and WI-38), as disclosed in the manufacturer’s package insert. I personally have a problem with the ethics of using aborted fetuses to grow the viruses used for this vaccine. The story of the very questionable ethics and greed involved in the development of these human diploid cells is quite disturbing indeed.6

  3. Measles poses a large threat to society, specifically to those who are physiologically unable to receive a vaccine as well as the young and old. This makes receiving the vaccine a responsibility for the majority of us who can safely do so. It is a shame that even with such an effective vaccine available, measles continues to burden society as a life threatening illness. It is because of this that King County needs to strictly enforce the school vaccination policies that are in place. Despite these policies being active, there are still large fluctuations between schools and districts in terms of vaccination rates, which shows that there is more we could be doing in order to prevent measles from spreading. While the responsibility of vaccinating a child falls to the caregiver, both the county as well as specific school districts need to take on the role of educating parents and families about the importance of vaccinating. It is necessary to educate and answer questions on this subject due to the anti-vaccination movement, largely driven by fear tactics and misinformation, which has caused many parents to question what the best choice is for their child. These uncertainties must be met with honest answers from a well-qualified healthcare professional in order to continue to reduce the number of anti-vaxxers in our community and thus reduce the risk to public health. As long as individuals are continuing to opt out of preventing a deadly disease from spreading, simply because of their own ideals, individual liberties must come second to protecting the public health of our community.

  4. Measles poses a large threat to society, specifically to those who are physiologically unable to receive a vaccine as well as the young and old. This makes receiving the vaccine a responsibility for the majority of us who can safely do so. It is a shame that even with such an effective vaccine available, measles continues to burden society as a life threatening illness. It is because of this that King County needs to strictly enforce the school vaccination policies that are in place. Despite these policies being active, there are still large fluctuations between schools and districts in terms of vaccination rates, which shows that there is potentially more we could be doing in order to prevent measles from spreading. While the responsibility of vaccinating a child falls to the caregiver, both the county as well as specific school districts need to take on the role of educating parents and families about the importance of vaccinating. It is necessary to educate and answer questions on this subject due to the anti-vaccination movement, largely driven by fear tactics and misinformation, which has caused many parents to question what the best choice is for their child. These uncertainties must be met with honest answers from a well-qualified healthcare professional in order to continue to reduce the number of anti-vaxxers in our community and thus reduce the risk to public health. As long as individuals are continuing to opt out of preventing a deadly disease from spreading, simply because of their own ideals, individual liberties must come second to protecting the public health of our community.

  5. Measles have a great threat to the health of people. The outbreak is a result of many people who choose not to vaccinate which is greatly influenced by anti-vaccination movements. The main argument for anti-vaccinations is the value of autonomy. There is an important component of respecting peoples decisions for themselves. However, the issues arise when it begins to pose a threat to others. The herd immunity of a population will decrease with more people acquiring measles and if vaccines against measles are not being taken by individuals who are not immune compromised. Another argument, that anti-vaxxers claim is that vaccines cause autism. Science and many authentic sources has proven that vaccines do not cause autism, so the points against this are irrelevant. Not only that, the vaccination against measles is proven as this article states to be highly effective in treatment. I think this outbreak teaches us a major lesson on how we can make better choices by vaccinating.

    Protecting the health of people in our community brings the best outcomes to every individual living in it. The discovery of vaccines and their benefits is a public health turning point to eradicate some major diseases. We need to acknowledge the advancements that have happened in public health in order to prosper in the health of our communities.

  6. According to the CDC, “Measles was declared eliminated (absence of continuous disease transmission for greater than 12 months) from the United States in 2000”, however, here we are in 2019 seeing an outbreak of measles (1). Why? Vaccine hesitancy among antivaxxers.

    There are different reasons for vaccine hesitancy among parents including religious reasons, personal beliefs, safety concerns, and a desire for more information regarding vaccines. Perhaps the most common argument against vaccination is that the MMR vaccination can cause autism in children due to a study that a medical researcher named Andrew Wakefield published in 1998. This study has since been discredited but the stigma around the MMR shot remains to this day.

    The problem with measles is that it is “so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected” (2). As stated in the above article, just two doses of the MMR vaccine provides over 95% protection against measles. The measles vaccine is proven to be highly effective and safe, yet some parents still choose not to vaccinate their children, putting all other people, especially vulnerable populations, at risk for this untreatable viral disease.

    It is deeply saddening that antivaxxers would rather put their individual liberties, personal perceptions and beliefs above the safety and protection of those around them. If you are an antivaxxer reading this, please vaccinate your children. It is not about you, it is a matter of social ethics and justice for all with respect to public health.

    1. Measles (Rubeola). (2018, March 19). Retrieved February 9, 2019, from https://www.cdc.gov/measles/about/history.html

    2. Measles (Rubeola). (2017, March 03). Retrieved February 9, 2019, from https://www.cdc.gov/measles/about/transmission.html

    1. Happy survivor of all childhood illnesses and have lifelong immunity. Those antibodies I carried were passed onto my children. Now that I see the hysteria and actually spent time looking at the evidence which unfortunately had to done by independent researchers and groups, I am appalled. Belly aching about what measles illness is? Try lifelong debilitating disease of individuals. Shame on this account. The trust of offical is going down the tubes. It is independent researchers that takes an honest look at the facts, debunks studied done by the FDA. It’s a pleasure to see that whistleblowers are organizing and reciting just how corrupt the CDC and FDA are. How short is the memory of those that lived through the tobacco investigations. Putting the lives of children at risk? The facts are far from clear in posts like these. If the goal is to remove vaccine hesitancy than it is lost because it is not take seriously by so called officials. No vaccine is always safe, no vaccine is always effective and no vaccine is always needed. Far more damage is done to children who receive the MMR than those that don’t. Safety testing is NOT done and it’s high time that it were done. How many vaccines are waiting in the pipeline?

      I am very proud of the young moms and families that showed up in Olympia last week to be heard.

  7. In situations like these, it is crazy to think that individuals are still not being vaccinated due to irrational fears that the vaccine can ultimately provide a worse outcome to a person than the disease itself. However, it has been proven that these vaccines are safe through scientific evidence. There should be no reason to not vaccinate one’s child for an extremely contagious and potentially deadly disease. It is necessary as well to keep in mind the ethical aspect of a policy that would require vaccines among all individuals. Implementing something like this would benefit the health of the entire community—social justice. It would be protecting the health of individuals that are unable to receive these vaccines due to existing health conditions. Implementing a required vaccine policy would also have no harm on individuals. However, creating a law or policy those forces someone to do something ultimately takes away their autonomy. To me, when the health of vulnerable populations is at stake, the good would outweigh the bad in this situation. It is also necessary to note that when policies are created, there will always be dissent. Not everyone will be happy, but in the end the overall population’s health will benefit and the vulnerable will be protected, which is most important.

  8. I believe that people should get vaccinated for the measles vaccine but we should change our tactics about how we talk to those who may not have vaccinated themselves or their kids. In the media today, we scrutinize anti-vaxxers and blame them for these outbreaks when we should be listening to why they are not vaccinating their child. So many people still believe that anti-vaxxers think that the vaccine can give autism or some other condition which is entirely untrue. Most anti-vaxxers want to know more about the ingredients in the vaccine, or they are worried about the amount of chemicals that are in vaccines going into their baby’s body and want to stretch out the timeline to get all the different vaccines as far as they can because they are worried the added chemicals may affect the baby’s development. Another idea that anti-vaxxers have is their distrust of the field of medicine’s history in the United States regarding minority populations. This stems from the Tuskegee Trials and many other medical studies that violated the rights and morals of the African American population. I believe if we can change our tactics and talk about the real misconceptions there are about vaccinations then more people will be willing to give their child the vaccine, but we have to stop blaming and scrutinizing people who don’t give their children the vaccine since it is multifaceted and many people have legitimate reasons why they chose to wait or not give their child the vaccine.

  9. I believe that people should get vaccinated, but we should change our narrative about how we talk to different populations of anti-vaxxers and those unsure of vaccinations. I believe changing the narrative about how we talk about vaccinations would be more successful because we scrutinize, pressure, and make fun of those who are unsure of the vaccinations and do not make a clear effort to understand why.

    A common reason some populations aren’t vaccinated are due to religious reasons. The United States being a place where people have the freedom to exercise their religious beliefs creates a social justice issue if we force these populations to get vaccinated even if their religion may say something else.

    Another common idea is that many people want to expand the timeline of when their baby is able to get vaccinations since in one vaccine, there is a lot of additional chemicals. I do not know much about what is in vaccines but I am assuming these chemicals help with the effectiveness of the vaccine and opening up dialog of what each ingredient does may help some parent feel at ease about what they are giving to their child.

    Another issue is the fear around vaccinations. Some minority communities are wary of medicines they are given due to the many injustices that they were faced with such as the Tuskegee Study Trials which targeted and tested on African Americans without their consent. These trials are still somewhat recent in our history which makes some communities feel wary that vaccines may be in the same boat.

    Lastly, our ideas of what anti-vaxxers are and what they believe vaccines do is very outdated and by opening up a non-judgmental dialog to alleviate some of these fears may help with more people getting vaccinated.

  10. Yes, we live in a country where people have rights to the choices they make for their own well-being and the well-being of their children. Though without proper knowledge that does not mean anything. False information was spread and has since created a ripple effect, causing more parents to be wary of making the choice to vaccinate their children. From a health care standpoint we must continue to teach the importance of vaccines though do it in the correct settings and the correct way and not by bullying anti-vaxxers. We must strive to understand why they are making these choices and reassure them that in order to make the right decision they must look at it holistically, weighing the pros and cons. Difficult medical jargon can also make it difficult to communicate the importance of vaccines effectively to all populations. I understand the mistrust, though having heard of instances where parents choose not to vaccinate simply because they can, is baffling.

    I stand on the side of education, while I am extremely pro vaccines, I choose not to discredit anyone that is not. Everyone has their reasoning. Though, I would just hope that for the sake of their children, they are fully educated on why they are making that choice and not letting false information and social media cloud their judgement. I would also urge that if you are choosing to not vaccinate you disclose that information often, so to not impact anyone that cannot be vaccinated due to health issues.

      1. My message is to change our approach for talking about vaccinations especially in communities that aren’t vaccinated. I agree that non vaccination is a health threat but we need to change our approach to understand why people don’t chose to vaccinate

Comments are closed.