Notes from the Field: Community Outbreak of Measles — Clark County, Washington, 2018–2019

Weekly / May 17, 2019 / 68(19);446–447

Alyssa Carlson, MPH1; Madison Riethman, MPH1; Paul Gastañaduy, MD2; Adria Lee, MSPH2; Jessica Leung, MPH2; Michelle Holshue, MPH3; Chas DeBolt, MPH4; Alan Melnick, MD1 (View author affiliations)

On December 31, 2018, Clark County Public Health (CCPH) in Washington was notified of a suspected case of measles in an unvaccinated child, aged 10 years, who had recently arrived from Ukraine. The patient was evaluated at an urgent care clinic for fever, cough, and a maculopapular rash. CCPH launched a case investigation, conducted contact tracing, and facilitated specimen collection and shipment to the Washington State Department of Health Public Health Laboratories. On January 3, 2019, measles virus was detected in the patient’s urine and nasopharyngeal specimens by reverse transcription–polymerase chain reaction (RT-PCR). By January 16, among 12 patients with suspected measles reported to CCPH during January 11–14, all had laboratory-confirmed measles by RT-PCR. In response to these confirmed cases and additional suspected cases, CCPH’s Incident Management Team was activated on January 15. Approximately 200 persons participated in the multiagency response, which included CCPH, the Washington State Department of Health, and CDC. As of March 28, 2019, measles had been confirmed among 71 Clark County residents, with rash onsets from December 30, 2018, to March 13, 2019.