Posted March 5, 2025. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.
Public Health Seattle King County has identified one confirmed cases of measles (rubeola) in an infant who was exposed to the measles virus while traveling outside the United States. The case was present at the following locations and dates during the infectious period:
| Date | Time | Location |
|---|---|---|
2/20/25 |
6-9 p.m. |
Apple Store at Bellevue Square |
2/21/25 – 2/22/25 |
10:30 p.m.-2:15 a.m. |
Seattle Children’s Hospital Emergency Department |
2/24/25 |
1-4:15 pm |
Allegro Pediatrics – Bothell |
2/25/25 |
1-4:00 p.m. |
Northwest Asthma & Allergy Center |
2/25/25 |
2:30-5:30 p.m. |
Seattle Children’s Hospital Emergency Department |
Whenever possible, contacts of a measles case are notified of their exposure. However, in public exposure settings it is not possible to determine all who may have been exposed.
If susceptible persons were exposed to this individual at the public locations identified, we would expect to see resultant cases become ill between 2/27/2025 through 3/18/2025.
At this time, we are not aware of additional cases in Washington, however, we urge your office to be prepared for handling potential cases of measles. If additional exposure sites/times become known, we will list them on For Healthcare Providers | SRHD under the Advisories & Alerts section.
As of March 4, 2025, the measles outbreak in Texas has grown to 159 cases, 22 of whom have been hospitalized. There has been one death in an unvaccinated school-aged child who lived in the outbreak area. Visit this link for the most recent updates: News & Alerts | Texas DSHS
Please be aware of this case and the measles outbreaks happening within the US and internationally when patients present with symptoms consistent with measles.
Use the Measles Quick Assessment for Providers (srhd.org) form to evaluate symptoms and for guidance on collecting and submitting specimens.
Report suspect measles cases immediately to SRHD Epidemiology:
We will consult with you regarding testing and specimen collection to determine if they meet criteria for testing at the WA State Public Health Laboratory.
Measles is a viral illness consisting of fever, cough, coryza, conjunctivitis (the “three Cs”), maculopapular rash, and Koplik spots. Usually, cold symptoms and fever precede the onset of the rash by two to four days, and a measles case will often feel ill enough to seek medical care BEFORE rash onset. If a patient has presented with coryza, light sensitivity, or cough with high fever and has a possible history of having been present at one of the locations mentioned above, please consider measles a possibility and notify SRHD immediately. The red rash usually begins on the face and spreads to the rest of the body. Koplik spots appear inside the mouth on the buccal mucosa and look like grains of sand (absence of Koplik spots does not rule out measles).
Ideally, a suspect measles case should bypass other patient waiting areas. Alert your reception staff on how to identify and isolate patients who present with these symptoms. Complications of measles can include otitis media, bronchopneumonia, laryngotracheobronchitis, diarrhea, and encephalitis.
Measles primarily spreads through large droplets but can also be transmitted through the airborne route. The virus can be transmitted through the latter route up to two hours after a contagious patient coughed or sneezed, according to the Centers for Disease Control and Prevention (CDC).
Preventing health care exposures is critical to keep high risk groups safe.
Please implement interventions listed below in your clinical settings to minimize exposure to others.
To potentially provide protection or modify the clinical course of disease among susceptible persons, either administer MMR vaccine within 72 hours of initial measles exposure, or immunoglobulin (IG) within six days of exposure. Do not administer MMR vaccine and IG simultaneously, as this practice invalidates the vaccine.
Individuals who should receive immunoglobulin (IG) due to severe disease and complications include:
Measles, mumps, rubella (MMR) vaccine is a two-dose series routinely recommended for children to be administered at 12-15 months of age and 4-6 years of age.
MMR vaccination is also recommended for adults if born in 1957 or later.
Current coverage rates in Spokane County are below the recommended herd immunity threshold of 92-94%. According to the Washington State Immunization Information System (WA IIS), as of December 27, 2024:
Reminder/Recall is a strategy used to identify patients who are due or overdue for vaccines. This strategy helps keep your patients up to date with recommended vaccines and can help mitigate the impact of community outbreaks. Spokane Regional Health District is recommending that all providers utilize this strategy to reach out to patients who are not up to date with their MMR vaccines.
Many electronic medical record (EMR) systems can generate a report of patients who are due or overdue for vaccinations. If your EMR doesn’t have this ability, you can utilize the WA IIS to perform a reminder/recall. Washington Department of Health (DOH) has a reference guide available on how to run this report.
DOH has created a web-based application for the public to access their immunization records in the Washington immunization registry. Patients can access this site as a strategy to reduce the number of requests for immunization records. Patients can sign-up for MyIR Mobile at myirmobile.com to view immunization records for themselves and their family members.
