Update (5.6.19): Latest locations/times are listed in the table below in bold.
Original post:
A Canadian resident from British Columbia who traveled to the Seattle area in late April 2019 has been diagnosed with measles. The traveler, a man in his 40s, has since recovered from his illness.
Prior to arriving in King County, he spent time in Japan and New York during the period that he was infected, two places that currently have measles outbreaks. This case has no connection to the recently-ended measles outbreak based in Clark County, Washington state.
While he was infectious with measles, he spent time in the Seattle area at several locations, including popular tourist attractions and Sea-Tac Airport. Anyone who does not have immunity to measles through vaccination or from previously having measles is at risk for infection if they were at a location of measles exposure.
“This case is another reminder that measles is resurgent in many areas of the United States and the world, and that because we all travel, no community is safe from measles introductions,” said Dr. Jeff Duchin, Health Officer for Public Health – Seattle & King County. “Measles vaccine is safe and effective – all adults and children should be sure they are up to date with the recommended doses of the vaccine to protect themselves and their community.”
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 April 27 and May 19, 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
The infected individual was in the following public locations; this list is not complete and will be updated on the Public Health Insider blog as new locations are confirmed.
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 (latest locations/times are listed in the table below in bold):
| Date | Time | Location |
| April 21, 2019 | 8 – 10 p.m. | Sea-Tac International Airport Gate A-5 to main terminal |
| April 24- 28, 2019 | Starting 10 p.m.4/24 to noon 4/28 | Marriott Courtyard Hotel Pioneer Square (612 2nd Ave, Seattle 98104) |
| April 25, 2019 | 11 a.m. – 1 p.m. | Storyville Coffee (1001 1st Ave, Seattle 98104) |
| April 25, 2019 | 5 – 7 p.m. | Kenmore Air Lake Union (950 Westlake Avenue N. Seattle 98109) |
| April 26, 2019 | 11 a.m. – 2 p.m. | Immediate Clinic Capitol Hill (1512 Broadway, Seattle 98122) |
| April 26, 2019 | 12 p.m. – 2 p.m. | Monorail (Westlake Station to Seattle Center) |
| April 26, 2019 | 2:30 – 6 p.m. | Seattle Space Needle (400 Broad St, Seattle 98109) |
| April 27, 2019 | 10 a.m. – 12:30 p.m. | Slate Coffee Roasters (602 2nd Ave, Seattle 98104) |
| April 27, 2019 | 11 a.m. – 4 p.m. | MoPOP – Museum of Pop Culture (325 5th Ave, Seattle 98109) |
| April 27, 2019 | 2:30 – 4:30 p.m. | Market Fresh (720 Olive Way, Seattle 98101) |
| April 27, 2019 | 9 – 11:30 p.m. | Tasting Room (1924 Post Alley, Seattle 98101) |
| April 27, 2019 | 9:30 p.m. – 2 a.m. | The Pink Door (1919 Post Alley, Seattle 98101) |
| April 28, 2019 | 10 a.m. – 12:30 p.m. | Slate Coffee Roasters (602 2nd Ave, Seattle 98104) |
| April 28, 2019 | 10:45 a.m. – 1:30 p.m. | Kenmore Air Lake Union, Flight M5 340 |
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 May 4, 2019.
Was this person vaccinated?
This individual had two doses of the vaccine, as recommended. The measles vaccine is highly effective in preventing infection, approximately 97% for people who have taken two doses.About 3 out of 100 people who get two doses of MMR vaccine will get measles if exposed to the virus. However, they are more likely to have a milder illness, and are also less likely to spread the disease to other people.
It is interesting that measles is resurgent in many areas in the United States after the recent outbreak of mumps on college campuses. The vaccine that protects individuals from mumps is also effective against measles so this makes me think that the outbreaks are very closely related. Since this most recent case was a man originally from British Columbia, did he originally pick up the virus from there, or Japan or New York? I am curious if the misconception about the association between the MMR vaccine and autism persists as strongly in other countries as in the U.S. According to “Our World in Data,” Canada had the lowest MMR coverage in 2017 compared to the U.S and Japan. This does not necessarily mean that Canada is the most likely place that the man contracted measles, but it is clearly an issue in many different places. In this article, I also would like to question the importance of laying out the man’s exact locations and times during his stay in Seattle. Although measles can remain in the air two hours after an infected person has left the area, it seems ineffective to scare people who were specifically in those areas. Exposing the person’s exact locations and times seem unethical as that information is personal. Giving so many details about the man (when his vacation dates and other destinations are also included) makes this person more identifiable to the public. I think enough wariness is created by emphasizing that everyone should find out if they have received the MMR vaccine and consult a physician if they have symptoms of measles, not just the people who were in those areas at that same time.
It is so weird that here in the United States, there is an ongoing debate on whether or not the government can enforce its citizens to get vaccinated. I think the state of New York is the first state to officially require all students to get vaccinated after breaking out in the largest outbreak of measles. The state of New York now requires every student enrolled or about to be enrolled in school to receive all their vaccinations. Just recently there is a public health policy that was published that banns children who are not vaccinated from being in public spaces. Unless children have a legitimate medical condition that leaves them immunocompromised, there is no excuse from getting vaccinated.
In Canada, on the other hand, at least in New Brunswick and Ontario, students are required to be immunized before enrolling in schools. If a parent fails to unvaccinated their child; he, she or they could be charged up to a thousand dollars. However, the vaccination policy in places like Alberta, Canada; the action is completely voluntary. The Alberta Province does not want to force children to get their vaccinations and leaves the decision entirely up to their parents since they are aware of the risks.
Now, Washington state has been added to the growing list of states with measles outbreaks (including New York, Oregon, California, Florida, Texas, and thirteen other states). 2019 has been the year with the most outbreaks above all other years, beating the year 2014 by over one hundred cases.