Health Care

Missourian with measles may have exposed kids in school, people in three other states

Getting vaccinated can help stop measles from spreading

Since measles is still common in many countries, unvaccinated travelers bring measles to the U.S. and it can spread. But you can protect yourself, your family, and your community with the measles-mumps-rubella (MMR) vaccine.
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Since measles is still common in many countries, unvaccinated travelers bring measles to the U.S. and it can spread. But you can protect yourself, your family, and your community with the measles-mumps-rubella (MMR) vaccine.

More cases of measles in students were reported in Missouri this week and health officials in three other states warned their residents that a traveler from Missouri may also have exposed them to the virus.

Bill Snook, a spokesman with the Kansas City Health Department, said there are now 10 cases of measles on the Missouri side of the metro, including three in students who attend Liberty Public Schools. Eighteen cases in Kansas also are linked to a separate outbreak that started in a Johnson County day care. Snook said seven more exposure sites in the Kansas City area will be announced soon.

Meanwhile, county and state health departments in Wisconsin, Minnesota and Iowa all released separate lists of hotels, gas stations and restaurants where a traveler with measles stopped between Friday, April 13, and Monday, April 16. A dollar store and a Catholic church were also on the lists, for a total of 11 public exposure sites.

Kerri Tesreau, the director of the Missouri Department of Health and Senior Service's division of community and public health, said it was the same Missouri traveler in all three states.

“From the information I know, I believe that was an individual who had been traveling not knowing they were ill,” Tesreau said.

The outbreak in Kansas is now the largest in that state since 1990, with 14 cases in Johnson County, three in Linn County and one in Miami County. That appears to be winding down, with the last case reported in early April.

A spokesman for the Kansas Department of Health said it's not related to the outbreak on the Missouri side of the metro that seems to be gaining steam.

The Clay County Public Health Center reported last week that a student who attends Warren Hills Elementary School in Liberty had the illness, but said there was no risk to other students or staff because that student had been absent during the entire period of contagiousness.

In letters sent to parents Tuesday, the county health center said there had since been two more cases confirmed, one in a student who attends South Valley Middle School and one in a student from Liberty North High School.

The high school student had also been absent the entire time he or she was contagious. But the middle school student may have exposed others at South Valley on Wednesday, April 18.

A spokesman for Liberty public schools said the school of almost 800 students has enacted its exclusion policy at the direction of the state and county health departments. Children who are not immunized are being held out of school during the three-week period when they might develop measles.

In Missouri and Kansas, parents are allowed to enroll their children in schools without the required measles-mumps-rubella, or MMR, vaccine if they exercise a religious or a medical exemption.

Kathy Ellermeier, the director of health services for Liberty Public Schools, said the overall exemption rate for the entire school district is about 1.5 percent, which is consistent with statewide averages.

She declined to release exemption rates for individual schools due to privacy concerns.

But she said none stray far from the district's overall rate.

“We don’t have a disproportionate number of people who are unvaccinated at one school,” Ellermeier said.

Ellermeier also said she was barred from talking about whether the three cases are members of the same family, or if they are linked at all.

But Tesreau said lab testing of the viruses in the three cases had revealed that they are the same type.

“It’s all from the same outbreak,” Tesreau said.

The CDC declared measles eliminated from the United States in 2000, but it's still prevalent overseas, and people who aren't vaccinated can bring it to the U.S.

Tesreau said the cases in Liberty may have come from an international traveler who lives in Missouri and was treated for measles at the University of Kansas Hospital last month. Unlike KDHE, her department is not ready to say for sure that the source wasn't the separate Johnson County outbreak, which started when a traveler to Asia brought measles back to the day care, where it spread largely among infants too young to be vaccinated.

“It does not appear to be, at this point, linked to the Kansas outbreak," Tesreau said. "But that’s preliminary.”

In all, the Kansas City metro area has had 28 confirmed cases of measles in the last two months.

Tesreau said that's unusual for the area, but it's a sign of the times.

“It is something you see happening more frequently throughout the country as vaccination rates have declined in areas and as there is more travel,” Tesreau said.

So far none of the 28 cases has resulted in serious complications, which include pneumonia and, in rare cases, encephalitis and death.

Members of the public are advised to get the MMR vaccine if they're unvaccinated and able. If they've been to exposure sites and develop symptoms like a high fever, cough and runny nose which precede the telltale rash associated with measles, they should contact their medical provider.

Tesreau said it's imperative they call ahead so medical providers can arrange to separate them from other patients. She also emphasized that people with the measles virus are contagious up to four days before they develop the rash.

“That’s why this is such a difficult illness to contain," Tesreau said.

The list of exposure sites in other states paints a picture of a road trip north on I-35 to Albert Lea, Minn., and then east to Winona, Minn., and LaCrosse, Wisc., along the Mississippi River.

Tesreau said her department is working with health departments in those states and with the federal Centers for Disease Control to track potential exposures.

In addition to those sites and South Valley Middle School, the other exposure sites associated with the Missouri outbreak are:

  • April 6 from 8:30 a.m. to 1 p.m. at the KCI Expo–Center Midwest Parent Educators Vendor Hall, 11730 N.W. Ambassador Drive.
  • April 10 from 9:30 a.m. to 2 p.m. at Nebraska Furniture Mart, 1601 Village West Parkway in Kansas City, Kan.

The only exposure site still active from the Kansas outbreak is:

  • April 8 from 10:30 a.m. to 1:30 a.m. in the lobby or sanctuary of the Cornerstone Presbyterian Church at 13300 Kenneth Road, Leawood.
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