Maryland Health Officials Try to Contain Spread of Measles

Health officials said yesterday 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 an 8-month-old have developed measles, a highly infectious virus characterized by a red skin rash.

Most Americans are vaccinated for measles, which has largely disappeared in the United States. But last year the number of cases doubled throughout the nation, which health officials attributed mostly to people who traveled overseas and might not be inoculated or have poor immune systems. The virus, which causes high fevers, can lead to pneumonia and, in rare cases, can be fatal to those who have not been vaccinated.

In Montgomery, a man contracted the disease while traveling abroad in February and infected an employee at his company, officials said. The employee sought treatment at Shady Grove Adventist Hospital on March 12 and while in the emergency room infected the 8-month-old.

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 congregants and also have tried to reach people who might have crossed paths with the person who was at Shady Grove's emergency room after 8 p.m. April 5, after 4 p.m. April 6 and the hospital's short-stay unit during most of the day April 7.

"We're hoping that we have contained this," county health official Carol S. Jordan said.

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 as long as 21 days after exposure for the first 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 in the mouth. There is no treatment, and patients must let the virus run its course.

Doctors at Shady Grove Adventist emphasized the importance of getting the measles vaccine. A first dose is given to babies between 12 and 15 months, followed by a second dose between the ages of 4 and 6. Adults might want to get a 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 measles cases point to a new challenge facing state health officials. Maryland boasts one of the highest rates of childhood immunizations, but the measles cases involve foreign-born residents who might have never been immunized, 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.

Federal health officials diagnosed an average of 63 measles cases a year between 2000 and 2007. But in 2008, that number more than doubled to 140 cases. As of last week, there have been 20 confirmed cases reported so far this year, according to the National Center for Immunization and Respiratory Diseases.