Health department warns of measles cluster among unvaccinated residents that originated with CHOP patient
A total of four cases have been confirmed. Health officials said that people who received the measles vaccine are not at risk
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A measles cluster that started with an infant hospitalized at the Children’s Hospital of Philadelphia last month has spread to at least three other unvaccinated city residents, Philadelphia health officials said Thursday.
The city has confirmed four cases of measles. Two additional possible cases are under investigation. The two unconfirmed cases are among people exposed to an infected person who spent time at a day-care center in violation of quarantine orders, the Department of Public Health said.
» READ MORE: One in five Philadelphia newborns is not protected from measles, CHOP-Penn study finds
“We are seeing cases of measles that have spread to vulnerable individuals, including young children, due to people declining vaccination and also failing to adhere to quarantine recommendations,” Philadelphia Health Commissioner Cheryl Bettigole said in a statement.
The department is contacting people potentially exposed to measles on the following occasions:
Jefferson Health building at 33 S. Ninth St. on Dec. 19 between 2 p.m. and 5:30 p.m.
Multicultural Education Station Day Care at 6919 Castor Ave on Dec. 20 and 21.
CHOP emergency department on Dec 28.
In addition, the department is investigating suspected exposure at:
St. Christopher’s Hospital for Children emergency department between the night of Dec. 30 and midafternoon Dec. 31.
St. Christopher’s Hospital for Children inpatient unit 5 North between Dec. 31 and Jan 3.
Nazareth Hospital emergency department on Dec. 31 and Jan 2.
Measles is a highly infectious virus that spreads through breathing in droplets or touching infected surfaces, according to the Centers for Disease Control and Prevention. The illness can be especially dangerous for children under 5, pregnant people, and those with weakened immune systems.
An unvaccinated person exposed to measles should isolate for 21 days.
The MMR vaccine provides protection against measles, mumps and rubella. People who were vaccinated are not at risk of exposure.
The health department wants unvaccinated people in any of the locations identified for known or possible exposures, and who are not otherwise immune to measles, to contact their health provider as soon as possible. That includes children under 15 months who typically have not yet had the MMR vaccine.
From CHOP to the community
Measles symptoms initially present like a regular flu-like illness, said Ericka Hayes the medical director of infection prevention at CHOP.
The rash that is characteristic to measles can appear four days after other symptoms begin. Before and after it appears, the infected patient can infect others. The measles virus stays in the air for two hours, making it very easily spread. This is why health officials require strict isolation for patients.
So when CHOP admitted an infant with fever in mid-December, two days passed before the rash appeared and a measles diagnosis was confirmed. The infant was recently in a country where measles is regularly occurring.
“Unfortunately, adjacent roommates were infected,” Hayes said.
Two hospitalized children were infected: an infant too young to have been vaccinated and a child whose parents had refused to vaccinate. The older child’s parents also refused medication that can prevent infection following exposure.
The unvaccinated parent of the older child who was hospitalized at CHOP is the fourth confirmed case.
» READ MORE: Philly health officials announced a possible measles exposure at a Center City building with Jefferson Health offices
In response to these measles cases, the hospital took isolation precautions and reached out to all potentially exposed people, Hayes said.
“It is absolutely safe to come to CHOP emergency departments and CHOP medical facilities,” she said.
Last month, health officials warned of a potential measles exposure at a Center City building with Jefferson Health offices, which health officials now say was related to the CHOP cluster.
On Wednesday, the health department learned that a person who had been told to isolate had violated the public health requirement.
What are the symptoms of measles?
A measles infection can lead to respiratory failure, inflammation of the brain, and death. Before the measles vaccines was available, 400 to 500 people died of the virus each year in the United States.
“MMR is an extraordinarily effective vaccine in preventing measles,” said Hayes, the infectious disease specialist at CHOP.
In 2000, after decades of vaccination efforts, the U.S. met the World Health Organization’s definition of having eliminated measles. Since then, the number of children receiving routine vaccines has decreased, especially since the start of the pandemic in 2020.
Experts now worry about outbreaks of a disease that once was no longer considered a threat in the U.S. In the fall of 2022, 85 children in central Ohio were sickened with measles. Of those, 80 were unvaccinated and 36 had to be hospitalized.
Last year, through Dec. 7, the CDC reported 41 cases nationally.
In Philadelphia, nearly 93% of children who attended kindergarten in Philadelphia public and private schools last school year had received at least two doses of the MMR vaccine, according to data from the Pennsylvania Department of Health. The statewide rate was 94%.