First Presumptive Positive Measles Case in Alabama for 2019

The Alabama Department of Public Health received notification of a case of presumptive positive measles the morning of May 2 in an infant in St. Clair County. Currently, this is the only presumptive measles case under investigation in Alabama.

The infant was considered contagious from April 23, 2019, through May 1, 2019. ADPH is working to confirm the diagnosis and to contact those exposed. The child is not in daycare and has had no out-of-state travel. So far in 2019, ADPH has conducted 174 investigations, including 32 open investigations, but this is the first presumptive positive case.

Measles (rubeola) is a notifiable disease in Alabama. The ADPH Immunization Division investigates reports of suspected measles. ADPH urges that all persons know their measles vaccine status. If never vaccinated and born after 1956, persons are strongly encouraged to obtain an MMR (measles, mumps, rubella vaccine) from their physician, healthcare provider or pharmacy. ADPH vaccine efforts primarily focus on children under 19 years of age. Free MMR vaccine is only available for children participating in the Vaccines for Children (VFC) Program and for persons who may qualify based upon local health department fee schedules.

ADPH has a very limited supply of MMR vaccine for adults and urges those with insurance and other coverage such as Medicaid to be vaccinated at their pharmacy or provider. About 95 percent or more of unvaccinated people exposed to a single case of measles will contract the disease.

For every single case of measles disease, 12-18 additional cases can be expected. The complication rate from measles is about 20-30 percent, especially in infants, children less than 5 years of age, and persons 20 years and older. Complications can range from ear infections and pneumonia to deadly encephalitis. For every 1,000 people with measles, one to two people will die.

Signs and symptoms of measles that occur before the rash are as follows:

• Patients develop fever, sometimes as high as 105 degrees, followed by cough, runny nose, and red eyes (conjunctivitis).
• Anywhere from 1-7 days after these symptoms begin, the rash develops.
• The rash starts on the face and spreads across the body.
• Patients may also have small white spots on the inside of the mouth on the cheek which may occur from two days before and up to two days after the rash.

From the time that a person is exposed to measles, it can take seven to 21 days for signs and symptoms to occur with an average of 10-14 days. People are contagious from four days before the rash develops until four days after.

For additional information, go to http://alabamapublichealth.gov/immunization/index.html