The U.S. Centers for Disease Control and Prevention (CDC) on Thursday sent a notice to health care providers to “stay alert for measles cases” after multiple outbreaks were reported in recent weeks along with an instance where an “international traveler” may have exposed thousands to the virus at two Washington-area airports.
The agency’s alert said that between Dec. 1, 2023, and Jan. 23 of this year, it received reports of 23 confirmed measles cases, “including seven direct importations of measles by international travelers and two outbreaks with more than five cases each.”
In the alert, it said that health care providers should take note of patients who have febrile rash symptoms as well as other related measles symptoms such as a cough or conjunctivitis or have recently traveled outside the United States, namely in countries with measles outbreaks.
It then said health care providers should “immediately” report the cases to state and local health agencies about suspected measles cases, which are then reported to the CDC
“Do not allow patients with suspected measles to remain in the waiting room or other common areas of the healthcare facility; isolate patients with suspected measles immediately, ideally in a single-patient airborne infection isolation room,” the agency said, or they are urged to wait in a private room with a closed door. “Healthcare providers should be adequately protected against measles and should adhere to standard and airborne precautions when evaluating suspect cases regardless of their vaccination status,” it said.
The agency also again recommended that people receive a vaccine for measles and pushed health care providers to recommend the shots. In 2023, the CDC sent out a similar health alert pushing for people to get vaccinated for the virus.
According to the alerts, the CDC said that most measles cases involve young children who haven’t received a measles-containing shot. Recent research, published in late December 2023, suggests if the measles vaccine is given after the diphtheria, tetanus, and pertussis vaccine—known as DTP or DTAP—there is an overall positive effect. If the order is reversed, a negative effect was observed.
Recent Cases
While the CDC did not go into specifics, health officials in the District of Columbia and Virginia issued notices about a “case of measles in a person who traveled through” area airports after returning from “international travel.”
That person traveled to Dulles International Airport in the international arrivals area of the main terminal between 4 p.m. and 8 p.m. local time on Wednesday, Jan. 3, as well as at the Ronald Reagan Washington National Airport’s Terminal A between 2:30 p.m. and 6:30 p.m. local time on Thursday, Jan. 4, according to the health agencies.
Health authorities are now working to identify people who may have been exposed to measles, including working to contact possibly exposed passengers on several flights, those alerts said earlier in January.
Neither statements from the Virginia and Washington health agencies listed the airlines or flights the infected person used. It’s also not clear what country the person had been traveling to.
In recent weeks, cases have been reported in Philadelphia, New Jersey, Kansas City, Delaware, and Washington state, according to various media reports.
Federal officials have confirmed at least 9 measles cases in Missouri, Georgia, New Jersey, and Pennsylvania as of Jan. 25, 2024. Over 1,200 measles cases have been confirmed since 2019, the CDC says.
Months before the COVID-19 pandemic started worldwide, health officials in New York’s Rockland County declared an emergency in 2019 after more than 100 people were diagnosed with the virus in the area. At the time, the declaration had banned minors who were not vaccinated for measles from appearing in public places, including shopping centers, schools, and restaurants.
Symptoms
Health authorities say that measles is a highly transmissible virus that spreads through the air when a person breathes, coughs, talks, or sneezes.
The virus generally shows up in two stages. In the first, most people develop a fever higher than 101 degrees Fahrenheit, runny nose, watery red eyes, or cough. These symptoms generally start seven to 14 days after being exposed.
Officials say the second stage of measles starts about two to three days after the initial symptoms. Some people develop what is known as Koplik spots—tiny white spots—inside the mouth, according to the CDC.
Three to five days after the first symptoms begin, the telltale measles rash starts to appear on the patient’s face near the hairline area before it spreads to the rest of the body, spreading downward, the CDC has said.
“Small raised bumps may also appear on top of the flat red spots,” and the “spots may become joined together as they spread from the head to the rest of the body,” the agency says. “When the rash appears, a person’s fever may spike to more than 104 degrees Fahrenheit.”
The CDC and the World Health Organization in November said that there were nine million measles cases and 136,000 deaths in 2022.
