PORT ANGELES — The North Olympic Peninsula’s public health officer said more cases of measles are possible after a second case was diagnosed in Port Angeles last week.
“Every time you get a secondary case like this, it raises the possibility that other people have been exposed,” said Dr. Tom Locke, public health officer for Clallam and Jefferson counties.
“You never know until it happens,” he added. “It’s possible but unknowable.”
A 5-year-old girl who attended kindergarten at Olympic Christian School at 43 O’Brien Road in Port Angeles was diagnosed with measles after being examined Wednesday at Peninsula Children’s Clinic, also in Port Angeles.
Hers was the second case diagnosed in the county this month.
She had not been vaccinated and had been in contact with a 52-year-old man hospitalized on Super Bowl Sunday with measles who has since recovered.
Those who could have been exposed to measles from the girl include those at the children’s clinic at 902 Caroline St. on Wednesday or on Feb. 6 at the school.
Olympic Christian School students who can’t prove immunity to measles are under quarantine until Feb. 27 — 21 days after their date of possible exposure Feb. 6.
Students at the private school must provide proof of measles immunity if they are to re-enter school Tuesday (Monday is the Presidents Day holiday).
Unimmunized students must stay at home, avoid public places and have no contact with people who are not immune to measles until the last Friday in February.
If more cases surface, health authorities would expect to see them the middle of this week or late in the week, Locke said.
“Given how contagious measles is and how we have a relatively high number of people who are susceptible in the population — those two things mixed together say there is a definite possibility,” he said.
The two cases of measles are the only ones confirmed in Clallam or Jefferson counties as of Saturday.
The girl, who is considered to have been contagious from Feb. 6 through Saturday, was quarantined away from the public at her home Wednesday night, Locke said.
Most people develop measles within 10 days of exposure, Locke said, but the incubation period can be as long as three weeks.
So the final day for cases of measles from the man — who visited several places in Clallam and Kings county during his contagious period — would be Feb. 22 and the last day for those from the girl would be March 4.
New cases — a third wave, as Locke put it — would extend the period.
“Every time we get a new one, the date extends,” Clallam County Health and Human Services Director Iva Burks said Friday.
Only those who are not immune and who were exposed could get the disease. Measles can linger in the air for two hours or so. An estimated 90 percent of people who aren’t immune to measles will catch the disease if they’re exposed.
Health authorities plan to list sometime this week the places and times other people may have been in contact with the girl, who was quarantined Wednesday evening in her Port Angeles home.
“This was a child, and at least she wasn’t going all over the place,” Burks said Friday.
Locke initially had said the 5-year-old had not been at the school while she was contagious but that he revised his estimate to include one day of exposure.
“I made the call,” Locke said Friday afternoon. “Now, we are proceeding as if a school exposure had occurred.”
Clallam County Health and Human Services employees and the staff of the private school worked Friday to determine which children and their families could be at risk of measles.
All those who were in the clinic waiting room Wednesday have been contacted, Locke said, and anyone who was a candidate for vaccination was vaccinated or otherwise treated, Locke said.
Babies too young to be vaccinated and older unvaccinated children were given emergency inoculations of gamma globulin, a temporary form of immunity, late Thursday after the case was confirmed. At least four people received this treatment, Locke said.
The measles vaccine is not effective outside a 72-hour window post-exposure, he said.
Locke said he could not reveal the time and place the man and the girl came into contact or the man’s place of employment.
He said that the man and girl were not members of the same family.
Tracing the man’s movements led health authorities to 96 people with whom he had come in contact — including a toll-taker on the Tacoma Narrows Bridge, Burks said.
Meanwhile, the source of Clallam County’s measles cases remains a mystery.
“The true index [first] case is where the 52-year-old man got it from,” Burks said.
The genotype of the virus that infected both the man and the girl Locke said the genotype is of “a new strain that hasn’t been detected in the state before” but that is common in Asia and the Philippines.
It is not the same as those of viruses that have turned up in Grays Harbor County and Vancouver, B.C. or as that of the so-called Disneyland outbreak that emerged in late December.
Measles vaccine is effective against all strains, he added.
Measles once was a common childhood disease that largely disappeared thanks to required immunization of schoolchildren.
However, Washington is one of 20 states that allow parents to exempt their children from vaccinations for personal, medical or religious reasons.
Nearly 20 percent of Clallam County kindergartners and more than 52 percent of such students in Jefferson County lacked complete immunity, according to statistics compiled by Clallam County Health and Human Services for the 2011-12 school year.
In Clallam County, about 7.2 percent of all school children were exempt from vaccinations in the 2013-2014 school year, according to state figures.
That means that their parents submitted signed forms citing medical, religious or personal reasons for not immunizing their kids.
Jefferson County has a 12.8 exemption rate.
At Olympic Christian during the 2011-12 school year, 18.4 percent of students, or 19 total pupils out of 82, were exempt, all for parents’ personal reasons.
Gary Rude, principal administrator at Olympic Christian, said those levels remain about equal in the current school year.
He said the school was closed Friday but probably would reopen after the Presidents Day holiday, although he would need to talk with the board of directors first.
As for the school’s teachers, “my sense of that is they’ve all had their shots,” Rude said.
That means they not only will not get measles, they cannot carry the virus, according to Locke.
“There is no carrier state with measles,” he said.
“If you’re immunized, you have nothing to worry about. If you’re not immunized, you should reconsider that decision.”
The child’s illness is the fifth measles case in Washington state this year. Nationally, at least 125 cases in 17 states and Washington, D.C., have been reported.
“With a second case of measles in the community and the possibility of more in the near future, all Clallam County residents should assess whether they are immune to measles,” Burks and Locke said in a news release.
“If they are in need of vaccination, they should make plans to receive it at their earliest opportunity.”
For details about measles, vaccinations, symptoms, morbidity and other information, visit http://tinyurl.com/PDN-CDCmeasles.
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Reporter James Casey can be reached at 360-452-2345, ext. 5074, or at jcasey@peninsuladailynews.com.
Managing Editor/News Leah Leach can be reached at 360-417-3531 or at leah.leach@peninsuladailynews.com.
