Maine reported their first measles case in 20 years yesterday, June 27, in a press release from the Maine CDC. Many other people may have been exposed and could show signs of infection soon, with the potential for outbreak brewing. The last measles case in Maine was in 1997.
Luckily, Maine has one of the highest rates of vaccination in the country: 96% of children between 19 months and 35 months are vaccinated against the disease, compared to the 91.9% US average. If the rest of the population in Maine has similar vaccination rates, that leaves about 4% of people unprotected, totaling about 50,000 people. Across the US, more than 100 people have gotten the measles year to date (as reported on June 17). That's already more cases than reported last year.
In addition the measles' characteristic red rash, symptoms include a cough, fever, reddened eyes, and runny nose. The rash typically starts on the face and spreads down, and Koplik spots (small white spots inside the mouth) can also appear within 2 or 3 days of symptoms beginning.
The infected person contracted measles while traveling abroad before going to Maine, visiting multiple locations in the state, apparently traveling to Quebec, and then returning to Maine the same day to go to the hospital. We don't know much else about the patient, such as where they were traveling when infected.
The person visited these seven locations, where it's possible the virus could spread to anyone else who visited during these times. Six are in Maine and one in Quebec:
- Narrow Gauge Cinema (Farmington, ME) Thursday, June 15, 4-9 pm
- Grantlee's Tavern and Grill (Farmington, ME) Thursday, June 15, 7-11 pm
- Farmington Farmers Market (Farmington, ME) Saturday, June 17, 8-2 pm
- The Kingfield Woodsman (Kingfield, ME) Sunday, June 18, 10 am - 2 pm
- Restaurant la Chocolaterie (Lac-Megantic, Quebec, Canada) Sunday, June 18, 12-4 pm
- Franklin Memorial Hospital Emergency Department Sunday, June 18, 8-10:30 pm
- Franklin Memorial Hospital Laboratory Monday, June 19, 12-2:30 pm
Anyone at those locations at the listed times could have been infected by breathing the air, or by touching a contaminated surface and then their eyes, nose, or mouth.
Measles can be transmitted through the air when someone infected coughs or sneezes, and through contact with contaminated surfaces for two hours after exposure. It takes between 10-21 days for symptoms to manifest, though typically happens within two weeks. Those infected are contagious from four days before the characteristic rash starts through four days after it ends.
The Maine CDC says that people who may have been exposed should "review their vaccine history and monitor for symptoms. Individuals with symptoms should contact their providers for instructions before arriving at the providers' offices or hospitals."
If you or someone you know was in any of these locations at these times, and then experienced symptoms that could be signs of measles, report it to a healthcare provider or call the CDC at 1-800-821-5821. You want to avoid the sick person from exposing too many others, and arriving at a healthcare facility without warning would likely do that.
People are protected from measles if they get the MMR (measles, mumps, and rubella) vaccine or the single measles vaccine. The CDC recommends everyone old and young gets vaccinated if they haven't, with the exception of those who are currently pregnant or otherwise immune compromised.
The more people vaccinated in a given population, the lower everyone's chance of exposure in the first place (fewer people get it and spread it), and they're less likely to be infected if they are exposed (your body can fight it off easier). It is sometimes possible to contract measles even while vaccinated, so those who might be exposed should still watch for symptoms, even if they've received the recommended vaccinations.
Measles can have severe and potentially fatal complications, including pneumonia (1 out of 20 cases), encephalitis (1 out of 1,000 cases), and ear infections (1 out of 10 cases). Encephalitis from measles can cause brain damage, and ear infections sometimes cause permanent hearing damage.
Prompt reporting of possible infection can reduce the risk of severe complications and of spreading the disease. Widespread vaccination is the most reliable way to prevent measles.