A laboratory confirmed case of measles was identified in an 8-month-old child visiting Seattle from Eastern Europe.  The infection was acquired before arriving in the United States.  The child was potentially contagious in the community (prior to diagnosis) between November 11 and November 17, 2005.

Healthcare providers are requested to be vigilant for measles among children and adults with symptoms compatible with measles.

Measles clinical case definition: An illness characterized by all of the following:

• A generalized rash lasting 3 or more days
• A temperature greater than or equal to 101.0° F (greater than or equal to 38.3°C)
• Cough, coryza, or conjunctivitis

NOTE: Measles cases may present with a nonspecific febrile illness before onset of the characteristic rash. The incubation period for measles is generally 8-21 days and the communicable period is approximately 4 days before rash onset to 4 days after rash onset. Measles cases should be treated with standard and airborne precautions in the hospital setting.

Laboratory criteria for diagnosis

• Positive serologic test for measles immunoglobulin M (IgM) antibody at the Public Health Laboratory
• Significant rise in measles immunoglobulin G (IgG) by any standard serologic assay
• Isolation of measles virus from a clinical specimen

Locations where measles transmission may have occurred:

1. Laurel Park Manor, 5010 NE 52nd St, Seattle, 98105, on November 11th 2005, from 2 p.m-6 p.m.
   
   
2. Larry's Market, 100 Mercer St, Seattle, 98109, on November 11th 2005, from 12 p.m.-4 p.m.
   
   
3. Old Navy, Factoria Mall, 4092 Factoria Blvd Southeast, Bellevue, 98006, on November 12th 2005, from 6 p.m.-10 p.m.
   
   
4. Larry's Market, 100 Mercer St, Seattle, 98109, on November 14th 2005, from 6 p.m.-9 p.m.
   
   
5. Buca di Beppo, 701 9th Ave N, Seattle 98109, on November 15th 2005, from 8:30 p.m. to 12:30 a.m.

Please report suspected measles cases immediately to Public Health at (206) 296-4774.  Public Health will facilitate laboratory testing for measles at the Public Health laboratory.  Please do NOT submit specimens to commercial laboratories for suspected acute measles cases.