Sacramento hospital sends letter warning roughly 220 patients
UC Davis Medical Center in Sacramento sent out a letter to roughly 220 patients treated on March 17 at the hospital, warning them that they may have been exposed to measles after a child treated in the emergency room on that date was found to be infected with the highly contagious virus.
The source of the potential exposure was an unvaccinated child from Calaveras County who was treated at the UC Davis Medical emergency room for respiratory symptoms on March 17, according to a statement made by County Health Officer Doctor Dean Kelaita to the Calaveras Board of Supervisors. The Calaveras County Health and Human Services Agency issued a press release on March 21, publicly confirming the measles case and recommending vaccinations, including the measles, mumps and rubella (MMR) vaccine. The letter recommended the first MMR vaccine for infants 12 to 15 months, and the second for children four to six years old.
According to Kelaita, Calaveras County has seen a decrease in the number of children vaccinated against measles. The press release noted that the unvaccinated child had traveled abroad before contracting the disease.
“The unvaccinated child resides in the Valley Springs area and developed measles after returning to California from traveling overseas,” the release said.
The release also warned that some Calaveras residents may have been exposed to the virus and that the department would be notifying individuals potentially at risk of infection.
“Prior to being diagnosed, the child had contact with several members of the public in Calaveras […] and Amador counties,” the release said. “Public Health officials are contacting the potentially exposed groups with information to prevent development of illness.”
Dean Blumberg, the chief of pediatric infectious diseases at UCDMC, said staff at his hospital did not suspect the child had measles and thus did not take typical precautions for treating a patient with a highly infectious virus.
“When the patient came to the emergency department, measles was not suspected, so they weren’t isolated, and measles is one of the most infectious diseases known to man — so that you don’t even need to have person-to-person contact to be infected,” Blumberg said. “So anybody who could even be breathing the same air within two hours could potentially be infected, because the measles virus stays suspended up in the air for up to two hours.”
After it was discovered that the patient had measles, Blumberg said, the medical center sent out a letter to roughly 220 of the people treated at the hospital the same day as the patient. The letter, posted online by CBS Sacramento, encouraged recipients to inform their healthcare providers of their potential exposure.
“You will need to notify your primary health care provider(s) and your child’s provider(s) of this possible exposure to discuss your possible risk of infection, vaccination history, and other questions you may have,” the letter read.
The letter explained some of the symptoms of measles, which include coughing, red eyes and a runny nose. Two to three days after the initial symptoms appear, “red, blotchy” rashes typically develop on the face, which soon spread to other parts of the body.
“This rash rapidly spreads downward to the chest and back and finally to the thighs and feet,” the letter read. “The rash fades after about a week.”
Though these symptoms may seem mild, Blumberg said, the illness can lead to more significant medical problems.
“Typically, patients with measles have fever, upper respiratory symptoms and rash, but it can result in complications such as dehydration, pneumonia and — in about one in every thousand cases — can result in death,” Blumberg said.
It seems that none of the patients potentially exposed to the virus on March 17 were actually infected, according to Blumberg, and the hospital has not seen any other related measles cases.
“We’re thankful that we feel there were no [secondary] infections that occurred from that exposure,” Blumberg said.
Blumberg said that measles outbreaks still pose a risk to Californians despite the successful containment in this instance. The Centers for Disease Control and Prevention, which declared measles eliminated in the U.S. in 2000, has noted a resurgence of measles outbreaks in America within the past decade, due in part to clustered communities of unvaccinated people. Blumberg said that in California these clusters often contain parents who are skeptical of vaccines and decide not to vaccinate their children.
“In California, what we worry about is many parents are vaccine-hesitant, and so they choose not to have their children vaccinated,” Blumberg said. “They tend to cluster within certain pools and communities — so if it entered one of those pools or communities, it could really just be transmitted very fast.”
As of 2019, there have been a total of 21 reported measles cases in the State of California, the highest concentration being in Butte, Calaveras, Shasta and Tehama counties. The thinly populated counties are listed together in the CDC website due to privacy concerns.
The best defense against measles outbreaks is vaccination, according to Blumberg.
“The vaccine works very well, so it’s recommended for people to get two doses of the vaccine, and that results in about 99% protection,” Blumberg said.