By Jenna Johnson
Washington Post Staff Writer
Monday, April 20, 2009; 5:29 PM
Health officials said today that a D.C. man was diagnosed with measles late last week, prompting authorities to retrace the his steps throughout the area to identify anyone else who may have exposed to the highly infectious disease and prevent it from spreading further.
This is the fifth case of measles in the region this year, but it is not related to the other cases. Still, the rare outbreak has prompted health officials in the District, Virginia and Maryland to focus on the small pockets of unimmunized individuals: Mostly, babies who have not yet been vaccinated and people who were born outside the U.S.
The District man contracted the virus during a three-week trip to India but did not show symptoms until after he returned home, said D.C. Department of Health Director Pierre Vigilance. Doctors believe the man's wife also has measles but they are still awaiting test results. Vigilance said the man had never been immunized, but wouldn't comment on his citizenship or why he had not been immunized.
"The reasons don't matter to us," Vigilance said at a news conference this afternoon. "We just want to contain this."
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By the time the man realized he had measles and sought medical attention, he had already visited eight places in the District, Northern Virginia and Montgomery County. County health officials have released a list of those places and urge any unimmunized people who visited those locations during a given time frame to contact their local health department. [See below.]
Usually the virus causes a red skin rash, high fevers and watery eyes, and lasts for about a week. It can take as long as 21 days after exposure for the first symptoms to appear. While most people recover within a week, measles can lead to pneumonia and, in rare cases, can be fatal. Anyone who thinks they might have measles is encouraged to call ahead before arriving at a doctors office or hospital to avoid spreading the virus to other patients.
Measles cases have nearly disappeared in the United States because a vaccination is required of all children attending public schools or foreign-born individuals who become U.S. citizens. Often measles outbreaks begin when an unimmunized person visits another country where measles is still prevalent and then returns to the U.S. The virus is most commonly spread through sneezing and coughing, and can remain in the air or on surfaces for two hours.
The other four measles cases were in Montgomery County. In February, a man contracted measles while traveling abroad and then infected a co-worker. That employee then went to Shady Grove Adventist Hospital in March, where he infected an 8-month old baby.
A fourth man was diagnosed with measles earlier this month, but his case is not related to the earlier ones. Officials have contacted people he may have come into contact with at Shady Grove's emergency room on the evenings of April 5 and 6, and the hospital's short-stay unit during most of the day April 7. They also contacted members of the man's church. So far, no additional cases have surfaced but people could still show signs as late as April 29, said Ulder Tillman, Montgomery County's health officer.
Given the nature of the outbreaks, Fran Phillips, Maryland's deputy secretary for public health services, said officials are looking into using a portion of the $3.8 million in stimulus money the state received for immunization programs to target adults.
"One of the difficulties we have is adults who were born in countries without an immunization mandate who can infect people who have not been immunized before,'' she said. "We are discovering that with international travel and with foreign born people living in Maryland there are communities of unimmunized people living in our midst.''
Here is a list of times and places where there was exposure to measles. Anyone who thinks they were exposed to the virus and has not been immunized or already had measles, should contact authorities at the following numbers:
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