Health officials said Monday that they are trying to contain Maryland's first measles outbreak since 2001, after a fourth case was diagnosed in Montgomery County.
Since February, three adults and a baby have developed measles, a highly infectious viral disease characterized by a red skin rash.
Most Americans are immunized against measles, which has largely disappeared in the U.S. But last year, the number of cases doubled throughout the nation, which health officials attributed mostly to people who traveled overseas and may not be inoculated or have poor immune systems. The virus, which causes serious discomfort and fevers, can lead to pneumonia and in rare cases can be fatal to those who have not been vaccinated.
In Montgomery County, a man contracted the disease while traveling out of the country in February and infected an employee at his company, officials said. That employee sought treatment at Shady Grove Adventist Hospital on March 12 and while in the emergency room infected an 8-month-old baby.
The fourth and most recent case was not related. Officials are following up on that person's movements over the past week. They have contacted the person's church to warn congregation members and also have tried to reach people who might have crossed paths with the person, who was at Shady Grove's emergency room April 5 after 8 p.m., April 6 after 4 p.m. and the hospital's short-stay unit during most of the day April 7.
"We're hoping that we have contained this," said county health official Carol S. Jordan.
Health officials urged people who think they might have the virus to contact their health care provider before going to an office or emergency room for treatment. It can take up to 21 days after exposure for the appearance of symptoms, which include a rash that starts on the face and neck and spreads, a high fever, runny nose, red eyes and small red spots with blue and white centers inside of the mouth. There is no effective treatment, and patients must let the virus run its course.
Physicians at Shady Grove Adventist emphasized the importance of getting the vaccine. A first dose is given to infants between 12 and 15 months, followed by a second does between the ages of 4 and 6. Adults may want to get an additional booster shot, especially if they will be traveling to areas where the virus is active, they said.
Fran Phillips, Maryland's deputy secretary for public health services, said the outbreak points to a new challenge facing state health officials. Maryland boasts one of the highest rates of childhood immunizations, but the most recent measles outbreak is happening among foreign-born residents who might never have received the vaccinations, she said.
"That is really quite a new development," she said. "But it does make sense that we see these cases in Montgomery County, which has one of the highest percentages of foreign-born residents."
Proof of measles immunization is required when children begin school and for immigrants seeking citizenship.
Rising infection rate
Federal health officials said an average of 63 cases of measles a year have been diagnosed between 2000 and 2007. But in 2008, that number more than doubled to 140 cases. As of last week, 20 confirmed cases of measles have been reported this year, according to the National Center for Immunization and Respiratory Diseases.