Disneyland measles outbreak spreads

An outbreak of measles that began at Disneyland before Christmas is disrupting lives in six states.

Seventy people have been diagnosed with measles, and hundreds more have been exposed at schools, doctor's offices, hospitals, shopping malls and other places visited by infected patients. Arizona became the latest state to report a case of measles related to Disneyland when a woman in her 50s was diagnosed. The outbreak has spread to Utah, Washington, Colorado, Oregon and across the border to Mexico.

As in earlier measles outbreaks, schools and hospitals prove to be hot spots for exposing large numbers of people to the virus, one of the most contagious diseases.

In California, two measles patients who visited the Oakland Medical Center's outpatient clinic exposed "less than 100" patients to the infection, says Stephen Parodi, director of hospital operations for Kaiser Permanente Northern California. On both occasions, Kaiser had to close off rooms that the measles patients had entered, to avoid spreading the virus, and contact any patients who may have been exposed.

In Colorado, health officials in El Paso County notified at least 250 people that they may have been exposed to measles at Penrose Hospital in Colorado Springs on Jan. 3, when an infected patient showed up for treatment. Patients may have been exposed in the emergency room, the CAT scan suite and the fourth floor.

Health officials in several California school districts told unvaccinated children to stay home after infected students showed up at school, says Gil Chavez, deputy director of the California Department of Public Health. Those students include 24 at Huntington Beach High School.

Measles poses a real risk at hospitals, because so many of the patients are critically ill, says Carol Baker, executive director of the Center for Vaccine Awareness and Research at Texas Children's Hospital, who has served on a vaccine advisory board at the Centers for Disease Control and Prevention.

Measles can linger in the air, infecting people even two hours after a sick person has left the room.

People who suspect that they or a family member have measles should not simply show up at a clinic or hospital, Parodi says. Instead, people should call ahead. That allows clinic staff to schedule the visit at a time when fewer patients are around. Patients may be asked to enter through a back door, where staff can give them a mask and user them into an exam room.

Measles was declared eradicated in 2000 in the USA, because it was no longer spreading routinely like colds or the flu. For several years after that, the USA saw only a few dozen measles cases each year, mainly infected travelers who were diagnosed here, according to the CDC.

The disease has made a comeback, reflecting the influence of huge measles outbreaks abroad — including more than 55,000 cases in the Philippines — as well as pockets of unvaccinated children here. Some parents hesitate to vaccinate their children, believing the discredited suspicion that vaccines cause autism. Last year, doctors diagnosed 644 cases of measles, according to the CDC.

The American Academy of Pediatrics sent out a notice urging parents to vaccinate their children.

Children typically receive a first measles shot around their first birthday and another before they start kindergarten, according to the CDC schedule.

One dose of measles vaccine is about 92% effective, and two doses are 98% effective, according to William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine in Nashville.

The outbreak is a reminder that protection from the measles vaccine can fade after a few decades, Baker says. People can get a blood test to measure their immunity to measles. These tests could be a good idea for those who are at high risk or who plan to travel to countries with large measles outbreaks can get blood tests to measure their protection, Baker says.

People planning an overseas vacation also can simply get another shot, she says. Even wealthy nations in western Europe have had large measles outbreaks in recent years, largely due to low vaccination rates.

This week, California health officials warned parents of unvaccinated children, including babies under 1 year old, to avoid Disneyland and other crowded venues that attract people from around the world.

Containing a measles outbreak is extremely expensive, Baker says.

In 2008, an outbreak in San Diego cost taxpayers $10,376 per case to trace contacts and administer vaccinations, the CDC says. That outbreak, started by an unvaccinated 7-year-old boy infected on a trip to Switzerland, grew to include 11 other unvaccinated children. At least 839 people were exposed to measles, and one patient — a baby too young to have gotten a measles shot — was hospitalized.

Measles causes major disruptions to patients and families, and many doctors may not recognize its symptoms, Baker says.

Its common symptoms include a fever, dry cough, runny nose, inflamed eyes and a telltale rash, according to the Mayo Clinic. Children are often so sensitive to light that they must be kept in a dark room. Children often develop ear infections and can develop both viral and bacterial pneumonia, Baker says.

About 35% of children under age 5 are hospitalized, says Eric Handler, health officer in Orange County, Calif. For every 1,000 cases of measles, one or two children die, according to the CDC.

Contributing: Associated Press