Measles Update — Potential Public Exposures in San Diego
Date: January 15, 2015
Seven more San Diego residents were confirmed this week to have measles linked to the Disneyland exposure on December 18, 2014. The California Department of Public Health (CDPH) reports that there are 25 cases confirmed in other California counties and four in other states. These numbers are expected to increase.
This is the updated list of locations where the measles cases may have exposed others in the county:
- Absolute Personal Fitness, 2000 Main Street, Julian, on Jan. 9 between 5:00pm and 7:00pm.
- City of San Diego Operations building, 1222 First Avenue, San Diego, on Jan. 12 from 6:30am to 4:00pm, Jan. 13 from 9:00am to 4:30pm, and Jan. 14 from 6:30am to 5:30pm.
- CVS Pharmacy, 2760 Fletcher Parkway, El Cajon, on Jan. 14 from 4:00pm to 7:00pm.
- Julian Fitness Center, 2216 Main Street, Julian, on Jan. 9 between 5:00pm and 7:00pm.
- Parkway Plaza Mall in El Cajon, Dec. 29 between 10:00am and 2:00pm, especially in or around GameStop, Sunglasses Hut, and the carousel in the mall.
- Rite Aid Pharmacy, 1665 Alpine Blvd., Alpine, on Jan. 13 between 4:00pm and 7:00pm.
- Sharp-Rees-Steely Urgent Care Clinic, 5525 Grossmont Center Drive, La Mesa, on Jan. 3 between 10:30am and 1:30pm and Jan. 14 from noon until the clinic was closed at 1:00pm.
- Trader Joe's, 5495 Grossmont Center Drive, La Mesa, on Jan. 12 between 4:00pm and 7:00pm.
- Vons, 2800 Fletcher Parkway, El Cajon on Jan. 14 from 4:00pm to 7:00pm.
Measles symptoms usually begin 10–12 days (up to 21 days) after exposure with a prodrome of fever as high as 105°F (40.5°C), malaise, cough, runny nose, and conjunctivitis. Three to five days following onset of the prodrome, a maculopapular rash develops. The rash usually begins around the ears and hairline and then spreads down to cover the face, trunk, arms, and legs. More information for providers may be found at the Centers for Disease Control and Prevention measles website.
Health care providers should:
- Consider the diagnosis of measles in patients with an appropriate clinical presentation. Any patient suspected of having measles should be masked and immediately moved to a negative pressure room when available. Providers seeing patients in an office or clinic setting should consider options such as having the patients call ahead when measles symptoms are present and arranging to see suspect measles cases after all other patients have left the office, or assessing patients outside of the building to avoid having a potentially infectious patient enter the office. Click here for CDPH guidance on healthcare facility infection control recommendations for suspect measles patients.
- Notify the County Epidemiology and Immunization Services Branch (EISB) immediately about any suspect cases during office hours by calling (619) 692-8499, Monday–Friday, 8:00am–5:00pm, and (858) 565-5255 after hours and on weekends. This will facilitate time-sensitive public health actions and assistance with clinical decision making.
- Do not wait for laboratory confirmation before reporting a suspect case. The County EISB staff can assist with facilitating testing, which includes a throat (or nasopharyngeal) swab and a urine specimen for measles PCR and culture and a serum specimen for measles IgM and IgG.
- DO NOT send potentially infectious suspect measles patients to a reference laboratory for specimen collection.
- Ensure staff and patients are up-to-date. Two doses of measles-containing vaccine (MMR vaccine) are more than 99% effective in preventing measles. Measles vaccines have been available in the United States since 1963, and two doses have been recommended since 1989. The first dose is given at 12–15 months of age, with the second dose usually at age 4–6 years. The second dose may be given any time ≥28 days after the first dose. All medical staff should have two documented doses of MMR or serologic evidence of measles immunity.
- Provide post-exposure prophylaxis when indicated. Click here for guidance from CDPH on measles post-exposure prophylaxis.
Thank you for your continued participation.
CAHAN San Diego
County of San Diego, Health & Human Services Agency
Epidemiology and Immunization Services Branch
Phone: (619) 692-8499 • Fax: (858) 715-6458
Urgent Phone for pm / weekends / holidays: (858) 565-5255
Email: cahan@sdcounty.ca.gov
Secure Website: http://cahan.ca.gov
Public-Access Website: http://www.cahansandiego.com
CAHAN San Diego Alerts are intended for the use of public health, medical and laboratory professionals in San Diego County. This alert has been approved for reproduction and distribution to interested professionals. An online CAHAN San Diego application is available at http://www.cahansandiego.com for appropriate and interested individuals.