The largest medical center in the Kansas City area is warning patients and employees they may have been exposed to measles.
The University of Kansas Hospital said Thursday that a person who was treated at the hospital from Friday, March 23, to Monday, March 26, has tested positive for the highly contagious viral illness.
Gerald Kratochvil, a spokesman for the Kansas Department of Health and Environment, said the KU case is not related to the current outbreak that started in a Johnson County day care and has sickened 13 people in three counties so far.
"The new case was contracted via international travel," Kratochvil said in an emailed response.
Measles is still common in parts of Europe, Asia, the Pacific and Africa, and unvaccinated people who travel to and from those regions have been known to carry it to the United States.
But it's very rare in the U.S., and Olathe Health Pediatrics doctor Elizabeth Musil said that between the KU case and the day care outbreak, the Kansas City area is experiencing an unusual level of measles activity right now.
“Certainly it’s not something we see frequently," Musil said, "which is good because it means the majority of people are getting vaccinated and doing the things they need to do to protect themselves and protect their children.”
Musil said people who have been vaccinated probably don't have to worry about getting sick in the current outbreak. But children under 12 months who are too young to be vaccinated, those who can't be vaccinated for medical reasons and those who refuse vaccinations are at risk.
Natasha Burgert, a pediatrician in Kansas City, said the current cases should remind people to make sure they're vaccinated before they go overseas.
"It's going to eventually have some sort of international source," Burgert said. "... When I talk to my infectious disease colleagues, that's where they're looking specifically: for travel histories. Because it has been eradicated in the U.S. and so we look to the other countries to bring it in, and Kansas City is a hotbed for travel."
Burgert said she expects more measles cases to emerge, based on the number of exposure sites and because anyone who was exposed has about a 90 percent chance of catching it if they weren't vaccinated.
“With measles being as infectious as it is, this is simply just a numbers game," Burgert said.
Exposure risk at KU and elsewhere
KDHE said people may have been exposed to measles in the KU Hospital emergency department waiting room between 10:45 a.m. and 1 p.m. and the emergency department patient care area between 10:45 a.m. and 9:30 p.m. on March 23. They could also have been exposed from 7:30 p.m. March 23 to 4 p.m. March 26 in the cystic fibrosis and medical telemetry units on the first floor and in the cafeteria between noon and 2 p.m. on March 25.
"Our top priority is the safety, health and well-being of our patients, employees and visitors," said Timothy Williamson, vice president for Quality and Safety for the University of Kansas Health System. "We encourage anyone who has not previously been vaccinated for measles and may have visited these areas during this time to contact their primary care provider to determine the most appropriate next step for them."
Measles exposure could be particularly dangerous for patients with compromised immune systems, including those with certain medical conditions and those undergoing chemotherapy.
Musil said those who get vaccinated are not only protecting themselves, they're also protecting those immuno-compromised people and infants to young to be vaccinated.
“It’s the herd immunity idea we’ve all probably heard about," Musil said. "The more people who are vaccinated in a community, that's going to protect their younger members, or even their older members whose immunity may be waning.”
KU Hospital is now the 14th identified public place where people in the Kansas City area might have exposed others to the virus recently. The hospital's announcement came one day after KDHE announced new cases and exposure sites in the day care outbreak that began earlier this month.
The others are:
- Chuck E. Cheese's at 15225 W. 134th Place, Olathe; 1-4 p.m. March 21
- Walgreens at 7500 Wornall Road, Kansas City, Mo.; 6-8 p.m. March 22
- Chick-fil-A at 12087 S. Blackbob Road, Olathe; 8:15 p.m. to close on March 24
- AMC Dine-In Studio 28 at 12075 S. Strang Line Road, Olathe; 3:30-7:30 p.m. March 9
- Aldi, 15290 W. 119th St., Olathe; 3-5 p.m. March 2
- Payless Discount Foods, 2101 E. Santa Fe St., Olathe; 10 a.m.-12:30 p.m. March 6
- El Potro Mexican Café, 602 N. Pearl St., Paola; 4-8 p.m. March 7
- Children’s Mercy Hospital Kansas (emergency department), 5808 W. 110th St., Overland Park; the mornings of March 8 and March 10
- Budget Coin Laundry, 798 E. Main St., Gardner; 8-11 p.m. March 9
- YMCA swimming pool and locker room, 21400 W. 153rd St., Olathe; 9:30 a.m.-1 p.m. March 10 and entire facility 8 a.m.-3 p.m. on March 22 and 23
- Bath & Body Works at Legends Outlets, 1803 Village W. Parkway, Kansas City, Kan.; 1-3 p.m. March 10
- Crazy 8 at Legends Outlets, 1843 Village W. Parkway, Kansas City, Kan.; 1-3 p.m. March 10
- Orange Leaf, 11524 W. 135th St., Overland Park; 3-6 p.m. March 10
The day care outbreak
People who were in the exposure areas at the times listed are advised to monitor themselves for three weeks for symptoms. The first symptom is fever, followed by cough, runny nose and watery eyes. After that a rash begins at the hairline and spreads down the body. People who become symptomatic are asked to stay home except to seek medical care — and even then to call ahead so health care providers can make arrangements to protect other patients.
Musil said her office is getting lots of calls from people who fear their kids might have been exposed. In some cases of confirmed exposure, the office has given an early vaccine or booster. But it takes 10 to 14 days for the shot to work, so it has to be given soon after exposure.
Wednesday's KDHE announcement brought the number of cases tied to the day care outbreak to 13. Eleven of the victims are Johnson County residents and the others are from Miami County and Linn County.
Health officials have declined to name the day care for privacy reasons, but have said that several of the early cases were in infants too young to get the vaccine.
Kansas law requires children who attend day care or pre-school to be immunized with an initial dose of the measles-mumps-rubella, or MMR, shot between 12 and 15 months of age, but parents are able to opt out for medical or religious reasons. According to KDHE, there's no law requiring day care workers to be immunized.
Measles usually resolves on its own after causing the telltale red rash. But it can cause serious complications, and people younger than 5 or older than 20 are at greatest risk. About 1 in 10 kids who get it also contract ear infections that can cause permanent hearing loss. About 1 in 20 get pneumonia.
More rare complications (about 1 in 1,000 cases) include encephalitis and even death.
Measles used to be relatively common, but after widespread vaccinated the CDC declared it eliminated from the U.S. in 2000. It still comes in from overseas, though. There were 118 confirmed cases in the entire country in 2017. But there are still occasionally high-profile outbreaks, including one that began at Disneyland in 2014.
According to the Centers for Disease Control and Prevention, most people who get the measles in the U.S. are not vaccinated, either for medical reasons, philosophical reasons, religious reasons or because they're too young.