TRAVERSE CITY — Measles, a disease that at one time had been eradicated in the United States, has been confirmed in a young woman from Grand Traverse County.
The woman had recently traveled to eastern Europe, where she likely contracted the highly-contagious disease, according to Dr. Michael Collins, medical director at the Grand Traverse County Health Department.
The woman had visited Munson Family Practice on Medical Campus Drive on July 2 and 3 before visiting the emergency room at Munson Medical Center on July 4.
By the time she went to the emergency room she had been sick for three days and was beginning to develop a rash, Collins said. Bloodwork was done to rule measles out, he said.
Because it was a holiday, there was a delay in getting lab results back until July 9, Collins said.
As soon as the measles were confirmed a press release was sent out, Collins said.
The woman was not vaccinated as a child because of a condition that prevented it, Collins said. Other family members are immunized, he said.
“We’re pretty optimistic in general because this person lives in a household where everyone is immunized,” Collins said.
Dr. Christine Nefcy is the chief medical officer for Munson Healthcare. Since an outbreak in southern Michigan earlier this year Munson, along with area health departments, has been working to educate medical personnel to be aware of possible measles cases.
“Since many of our younger physicians have never seen a case of measles, we’re reminding them of what the signs and symptoms are and to be on high alert when someone comes in with a rash and fever because it could be measles,” Nefcy said.
“Nowadays we don’t typically see that,” she said.
Measles is a respiratory infection caused by a virus that can live for up to two hours in the air after an infected person leaves the area.
It is prevented by a vaccine that is 95 percent effective after one dose and nearly 100 percent after two doses. Children receive the vaccine at about a year old and again before starting kindergarten, at about 5 years of age.
Measles symptoms usually occur 10 to 14 days after exposure, but can appear up to 21 days later. They include high fever, cough, a runny nose, red and watery eyes, and tiny white spots on the inner cheeks, gums and roof of the mouth.
At about three to five days a red, raised rash appears on the face and moves down the body.
For the first few days measles looks like a cold, Collins said.
“Most people would just think that you had a cold and chances are, statistically, that you would,” he said. “By the time the rash appears the person has been infectious to others for about four days.”
Nefcy said Munson has been working with the health department to track down all those people who were in the waiting room, contact them and check their immunization status.
Those who haven’t been immunized are encouraged to contact their doctors to get the measles vaccine.
The vaccine works if it is given within 72 hours of an exposure. Collins said that it is too late to prevent development of the disease from this exposure.
Those who develop symptoms should call their health care provider before showing up in person and exposing others, he said.
The local confirmation marks the 45th case in Michigan this year, compared to 19 in 2018.
It’s the highest count the state has seen since 1991, said Lynn Sutfin, Michigan Department of Health and Human Services spokesperson.
Measles was declared “eliminated” from the U.S. in 2000, according to the Centers for Disease Control and Prevention.
The CDC reports more than 1,100 cases of measles nationwide so far this year — a spike from the 372 cases in 2018.
“Not seeing these cases, people think vaccines aren’t necessary, because measles isn’t around,” Sutfin said. “We’re probably a product of our own success.”
In Michigan, 42 of this year’s cases resulted from an outbreak near Detroit, the result of a visiting ill traveler. It afflicted victims as young as 8 months old.
Grand Traverse had two confirmed cases — a couple — and Leelanau County three in 2014 — one adult and two children. The Leelanau residents were exposed by the Grand Traverse couple, who developed the disease after returning from a trip to the Philippines.
Neither the couple nor the Leelanau residents were immunized, according to information from the Benzie-Leelanau District Health Department.
Michigan has an overall vaccination rate — including measles, mumps, rubella and chickenpox — of 74 percent, according to the Michigan Care Improvement Registry.
Sutfin said she’s seen decreases in vaccination rates in some areas and a steady rise in waiver rates for Michigan schoolchildren, who with the proper paperwork can opt out of vaccinations and still attend class.
The drop leaves infants too young for their shots and the state’s immune-compromised populations more vulnerable.
“Community immunity,” Sutfin said, normally keeps those at-risk populations safe, as a disease can’t survive and spread through a population when enough people are protected.
Vaccination rates need to be at 90-95 percent to make that happen, Sutfin said.
Nefcy said it’s a shame that anybody gets measles because it is preventable.
“Vaccines are safe and highly effective,” Nefcy said. “Everybody should get them.”
Brooke Kansier contributed to this article.