Person with measles exposed others at University of Michigan dorm, hospital, 4 other sites
A person contagious with measles visited a dorm at the University of Michigan, the emergency department at University of Michigan Medical Center, two CVS pharmacies and two urgent care centers March 10-March 15, the Washtenaw County Health Department reported Thursday.
This is the second measles case in Washtenaw County this year and the fourth known case in Michigan in 2024, said Chelsea Wuth a spokesperson for the Michigan Department of Health and Human Services.
The person did not have immunity to measles, is not a student or affiliated with the University of Michigan, and is between the ages of 18-49, said Susan Ringler Cerniglia, public information officer for the Washtenaw County Health Department.
Kim Broekhuizen, a spokesperson for U-M, said the contagious person was "an authorized visitor" of the Alice Lloyd residence hall, where an exposure was reported 6:45-9 a.m. March 11.
"U-M’s Department of Environment, Health & Safety is reaching out to residents and staff of the Alice Lloyd Hall with guidance on symptom monitoring and steps to appropriately seek testing and care if symptoms develop," Broekhuizen told the Free Press.
"University officials are working closely with the county health department and continue to monitor the situation."
Students who develop symptoms have been advised to contact University Health Service by emailing ContactUHS@med.umich.edu to arrange for necessary testing and care so that precautions can be taken to avoid exposing others.
Where people may have been exposed to measles
The measles virus is so contagious that it can live for up to two hours in the air after a person with measles leaves the room, and 90% of people who are unvaccinated or don't have immunity to the virus become infected after exposure.
Anyone who was in the following places during these dates and times may have been exposed:
University of Michigan Medical Center, Michigan Medicine adult emergency department and waiting area, 1540 E. Hospital Drive, Ann Arbor: Two exposure dates and times: 10:40 a.m.-4 p.m. March 10 and 7:30-10 a.m. March 11.
University of Michigan Alice Lloyd Dormitory, second floor, 100 Observatory, Ann Arbor: 6:45-9 a.m. March 11.
CVS Pharmacy, 5449 Jackson Road, Ann Arbor: 3:20-5:40 p.m. March 11.
NextCare Urgent Care (formerly Michigan Urgent Care), 3280 Washtenaw Ave., Ann Arbor: 10:40 a.m.-2:15 p.m. March 12.
CVS Pharmacy, 3535 Plymouth Road, Ann Arbor: 4:45-7 p.m. March 14.
Trinity Health IHA Medical Group, West Arbor Primary Care and Urgent Care, lobby and waiting area, 4350 Jackson Road, Ann Arbor: 11 a.m.-3 p.m. March 15.
The Washtenaw County Health Department asks people to monitor for measles symptoms for 21 days after the date of exposure. If symptoms develop, call ahead before visiting a doctor, urgent care, or hospital emergency room to avoid exposing others.
“This situation illustrates why we work so hard to contain measles,” Dr. Juan Luis Marquez, medical director for the Washtenaw County Health Department, said in a statement. “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.”
More: State's top doctor: Measles outbreak likely in Michigan because of low vaccination rates
Cerniglia said the person with the most recent measles infection is not hospitalized and is recovering well.
"We are working closely with all involved sites and partners to alert people to the potential exposure," she said. But with this many people potentially exposed, that's a difficult job.
"We and our partners are prioritizing those most vulnerable as much as possible," such as infants and children, severely immunocompromised kids or adults and those without prior immunity, she said.
What are the symptoms of measles?
Measles symptoms typically begin seven to 14 days after exposure, but can first appear as long as 21 days after exposure and can include:
High fever that could reach 104 degrees or higher.
Cough.
Runny nose.
Red, watery eyes (conjunctivitis).
Tiny white spots on the inner cheeks, gums and roof of the mouth called Koplik Spots, which usually appear two to three days after symptoms begin.
A rash that starts on the face and spreads to the trunk, arms and legs, typically three to five days after symptoms begin. The rash is red, raised and blotchy.
How difficult is it to diagnose measles?
Diagnosing a measles infection can be challenging, especially in the early stages, Cerniglia said.
"The early symptoms are not distinct ... and very similar to many other viruses/respiratory illnesses," she said. "This is why being alert to possible exposure is so important. Individuals are contagious during this initial phase, which is prior to the rash appearing."
People with measles become infectious four days before the rash begins and continue to be infectious until four days after, she said.
"Additionally, many viruses/conditions can cause rash. It can be very hard to distinguish, especially earlier. Testing may also take multiple days," she said.
Health department urges vaccination
Measles infections are preventable with widespread vaccination. Two doses of the measles, mumps and rubella vaccine (MMR), offers 97% protection from infection. A single dose is about 93% effective.
However, in Michigan, immunization rates have fallen to 66% among Michigan toddlers — the lowest point in more than a decade for recommended childhood immunizations, according to MDHHS.
"Our message remains the same: get vaccinated," Wuth said. "Measles vaccines are incredibly effective. Measles has tremendous outbreak potential in persons who are not immune. Vaccination is key and is highly effective in preventing measles. We urge people to be aware of measles exposures may have occurred and monitor for signs and symptoms of measles."
Those who suspect they may be infected should call ahead before going to a hospital, urgent care, doctor's office or pharmacy, Wuth said.
What is the recommendation for measles vaccinations?
The U.S. Centers for Disease Control and Prevention recommends:
A first dose of the MMR vaccine for children ages 12-15 months old, with a booster dose administered between ages 4 and 6.
Anyone born during or after 1957 without evidence of immunity against measles or documentation of having been vaccinated with two doses of MMR vaccine should get vaccinated with two doses. The second dose should be given no sooner than 28 days after the first.
Two doses are recommended for adults at high risk, such as international travelers, college students and health care personnel born during or after 1957.
People exposed to measles who cannot document immunity against the virus should get post-exposure prophylaxis — a dose of the vaccine to potentially provide protection within 72 hours of initial exposure, or immunoglobulin within six days of exposure.
4 Michigan cases don't meet definition of outbreak
Although Michigan health leaders have reported four measles cases over the last month, it doesn't yet rise to the level of an outbreak, according to the definition set by the CDC, Wuth said.
"CDC defines a measles outbreak as a chain of transmission including three or more cases linked in time and space," she told the Free Press Thursday.
However, only one case in Michigan — the most recent — has been linked to an exposure to another contagious person in the state.
The person who is now infected with measles was likely exposed to the virus at Trinity Health Ann Arbor's waiting and triage area, where another Washtenaw County resident contagious with measles had gone for help, Cerniglia said.
It is the first time this year that a measles infection was spread from person to person in Michigan. The other two Michigan measles cases were distinct and occurred following international travel among unvaccinated people from Oakland and Wayne counties, state health officials said.
Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Free Press.
This article originally appeared on Detroit Free Press: Measles exposures reported at U-M hospital, dorm, CVS, urgent cares
