Washtenaw County detects second measles case this month

The Washtenaw County Health Department reported its second case of measles this month and what the state confirmed is its fourth case, indicating in a Thursday news release that the virus was detected in an adult without measles immunity who was exposed to the first case reported in Washtenaw on March 3.

Measles is highly contagious and is spread from person to person through the air. The virus can live in the air for up to two hours after an infected person leaves a space, according to the Centers for Disease Control and Prevention. The latest individual who got infected didn't have immunity through a vaccination or a prior infection, according to the Washtenaw County Health Department.

The symptoms of measles — which include a high fever, cough, runny nose, red or watery eyes, white spots in the mouth, and a red, raised, blotchy rash — typically begin within seven to 14 days but can appear as many as 21 days after exposure. Roughly one in every five people with measles will require hospitalization, and rarer, potentially fatal complications include pneumonia and encephalitis, according to the Centers for Disease Control and Prevention.

"Really each case of measles is considered an urgent situation and can be considered an outbreak. This case is significant because there is no known travel history and a link to the earlier reported case," Washtenaw County Health Department spokeswoman Susan Ringler Cerniglia said.

Prior to this, three unrelated cases of measles had been reported in Michigan. Besides the Washtenaw County case, there were one case each in Oakland and Wayne counties. The Michigan Department of Health and Human Services confirmed Thursday it is the fourth statewide measles case.

The Washtenaw County health department has identified seven community exposure points over six days:

• March 10: 10:40 a.m.-4 p.m., Michigan Medicine Adult Emergency Department and waiting area, 1540 E. Hospital Dr., Ann Arbor 48109.
• March 11: 7:30-10 a.m., Michigan Medicine Adult Emergency Department and waiting area, 1540 E. Hospital Dr., Ann Arbor 48109.
• March 11: 6:45-9 a.m., Second floor of the University of Michigan's Alice Lloyd Dormitory, 100 Observatory, Ann Arbor 48109.
• March 11: 3:20-5:40 p.m., CVS Pharmacy, 5449 Jackson Rd., Ann Arbor 48103.
• March 12: 10:40 a.m.-2:15 p.m., NextCare Urgent Care, 3280 Washtenaw Ave., Ann Arbor 48104.
• March 14: 4:45-7 p.m., CVS Pharmacy, 3535 Plymouth Rd., Ann Arbor 48105.
• March 15: 11 a.m.-3 p.m., Trinity Health IHA Medical Group WestArbor Primary Care and Urgent Care lobby and waiting area, 4350 Jackson Rd., Ann Arbor 48103

The Washtenaw County Health Department is asking anyone exposed to this new measles case to monitor themselves for symptoms for 21 days. Infected people can spread the virus for four days before a rash develops and four days after.

If symptoms develop, people should call ahead before visiting a doctor, urgent care or emergency room to reduce exposure to staff and other patients, the health department said.

"Measles diagnosis can be complicated, and there were multiple tests run in this situation," Ringler Cerniglia said. "The important date for us is when the case was infectious (four days before and four days after the rash starts). In this situation, that infectious period starts Sunday, March 10, which is when we have possible local exposures, unfortunately."

While measles was eliminated from the United States in 2000, meaning the virus was no longer constantly present, travelers can still bring the disease back and cause outbreaks in unvaccinated populations. Michigan confirmed its measles case since 2019 in Oakland County last month, along with two others in Washtenaw and Wayne in early March. While none of the first three cases were associated with each other, all were linked to international travel.

The Washtenaw County Health Department encouraged everyone to check their measles vaccination status and get the vaccine if they are not fully immune.

"This alert is more urgent for anyone potentially exposed to the confirmed case," Washtenaw County Health Department medical director Juan Luis Marquez said in the news release. "But it is also a critical reminder for everyone to check their vaccination status and confirm protection against measles."

Children can receive two doses of the measles, mumps and rubella (MMR) vaccine by the time they turn seven, according to the CDC. A single dose of the vaccine is about 93% effective at preventing infection while two doses are about 97% effective, according to the health department.

The vaccine can also prevent illness if administered within 72 hours of exposure to measles, but that window has elapsed for the latest Washtenaw case. Some people with weakened immune systems should not get the vaccine, the health department said.

Michigan last experienced an outbreak in 2019, with 46 confirmed cases.

"This situation illustrates why we work so hard to contain measles," Marquez said. "People without immunity from vaccination or a prior illness are very likely to become ill if exposed, and about 1 in 5 will require hospitalization."

hmackay@detroitnews.com