By LAUREN C. WILLIAMS
WASHINGTON (April 28, 2009) - The rapid spread of measles across the nation—including the link between a Maryland outbreak and a case in Missouri—is raising concern among health officials of a swelling unvaccinated population.
An eastern Missouri woman contracted measles during her stay in Maryland during an event at the 4-H Youth Conference Center in Chevy Chase, said Mary Anderson, spokeswoman for the Montgomery County health department.
It is suspected that the woman, 24, who left the area April 11, was infected by a Maryland woman, who was the state's fourth measles case this year. The Maryland woman attended church services at the center before seeking medical attention the previous Sunday.
"Something as simple as walking down the hallway, within hours" of each other can spread measles, said David Paulson, communications director for the Maryland health department.
The Missouri woman became ill after returning home and was not contagious during her stay in Maryland, Anderson said. The Missouri health department is monitoring her and others who may have been infected.
The Missourian's family is under voluntary quarantine. Those who accompanied her on the trip have been notified, said Susan Kneeskern, public health consultant nurse for Missouri's health department.
The Washington metropolitan area has seen seven cases of measles this year, following two years without infections. The spike in cases is sparking concern, not just for an outbreak, but about a growing unvaccinated population.
Maryland's last outbreak, in 2001, had four cases, three confirmed and one suspected.
It takes about 10 days after exposure to measles for an infected individual's symptoms to manifest and 14 days for a rash to develop.
Adults who did not start school in the U.S., babies under 12 months and children whose parents waived vaccination because of medical complications or for philosophical reasons are susceptible to the virus.
The highly contagious viral disease, typically characterized by a rash on the face and neck, has infected people in D.C., Maryland and Virginia. Two cases are isolated from the others, with causes unknown, the Maryland woman being one.
The other three of Maryland's four measles cases are related. The first was a restaurant owner who contracted measles on his trip to eastern Asia and on his return, infected an employee who sought treatment at Shady Grove Adventist Hospital where he infected an 8-month-old infant.
Cases five and six were a Washington couple who travelled to India and developed symptoms when they returned. The man was confirmed to have measles through laboratory testing while his wife was assumed to have measles given her proximity to her husband.
The most recent regional case was an adult male in Prince William County, Va., who hadn't travelled outside of the United States in the past 21 days and has not been associated with any other cases.
High vaccination rates have nearly eradicated measles in the U.S.; however, immunization rates focus on school-aged children and not adults. Immunization is recommended via the measles-mumps-rubella vaccine given to infants between 12 and 15 months and as a booster by age 6.
Virginia reported one travel-related measles case last year which followed a six years of being measles-free.
"Initially the concern is imported measles," said Denise Sockwell, epidemiologist, Virginia Department of Health.
"We don't know where he got his measles, which concerns us," and most U.S. cases start with an imported case, she said.
"At this point we may not ever know where he got this virus from," said Sockwell.
Most people fully recover from measles, but in some cases the virus can be fatal and cause complications such as diarrhea, pneumonia, and brain infection, which can result in permanent damage.
Sockwell said: "There could be other people out there who have the measles" and are not reporting it.
Capital News Service contributed to this report.