Fifth Case of Measles Cited in D.C. Area; Officials Retrace Infected Man's Steps

By Jenna Johnson
Washington Post Staff Writer
Tuesday, April 21, 2009

Health officials said yesterday that a D.C. man has measles, and authorities are retracing his steps earlier this month in the District and Montgomery and Arlington counties to determine whether anyone might have been exposed to the highly infectious disease.

It is the fifth case of measles in the region this year, but is not related to the others. The rare outbreak has prompted health officials in the District, Virginia and Maryland to focus on small pockets of unimmunized individuals, mainly babies who have not yet been vaccinated and people born outside the United States.

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. Health Department Director Pierre Vigilance. Doctors believe the man's wife also has measles and are awaiting test results. Vigilance said the man had never been immunized but wouldn't comment on his citizenship or why he had not been vaccinated.

"The reasons don't matter to us," Vigilance said. "We just want to contain this."

By the time the man realized he had measles and sought medical attention, he had already visited seven places throughout the Washington region. Authorities urged any unimmunized people who visited those locations during the time the man visited to contact health officials. (See list at right.)

The virus usually causes a red skin rash, high fever and watery eyes, symptoms that last for about a week. The first symptoms can appear as long as 21 days after exposure. Although most people recover within a week, measles can lead to pneumonia and, in rare cases, can be fatal. Those who suspect that they might have measles are encouraged to call ahead before going to doctors' offices or hospitals to avoid spreading the virus.

Measles cases are uncommon in the United States because vaccinations are required of most schoolchildren and foreign-born individuals who become U.S. citizens. Outbreaks often begin when an unimmunized person visits a country where the disease is still prevalent and then returns with the infection. The virus is usually spread through sneezing and coughing and can remain in the air or on surfaces for two hours.

The other measles cases were in Montgomery County. In February, a man contracted measles while traveling abroad and then infected a co-worker. That employee visited Shady Grove Adventist Hospital in March, where he infected an 8-month-old baby.

A fourth man learned he had measles earlier this month, but his case is not related to the others. Officials have notified people with whom he might have come into contact at Shady Grove's emergency room on the evenings of April 5 and 6, and at the hospital's short-stay unit during most of April 7. They also contacted members of the man's church.

So far, no additional cases have surfaced, but signs of infection could appear as late as April 29, said Ulder Tillman, Montgomery health officer.

Staff writer Lori Aratani contributed to this report.

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