Doctors at Providence Holy Family Hospital’s emergency room didn’t immediately realize they were dealing with a measles case last week, hospital officials confirmed Wednesday evening.
The patient went to the ER Thursday night and was discharged Friday morning. By Sunday morning, the patient was back in the ER, when measles was identified as a possible diagnosis. At that time, hospital staff took precautionary measures and isolated the patient, officials said.
Measles symptoms initially mirror those of a severe cold, so a misdiagnosis isn’t unusual, said Dr. Joel McCullough, Spokane Regional Health District’s lead medical officer.
The rash doesn’t appear until three to five days after an individual comes down with a fever, sore throat and runny nose.
“You have to do a measles-specific lab test to confirm the diagnosis,” McCullough said. “Since we haven’t had an outbreak in Spokane County since 1994, another diagnosis would be more likely.”
But the delay potentially exposed more people to the highly contagious viral infection, which is spread by coughing and sneezing.
“We would not be surprised if there are more cases, given how infectious measles are and given how many people are not immune,” he said.
Providence officials said they are contacting all patients and caregivers who were at Holy Family during a time when they might have been exposed. Caregivers at risk of contracting the disease will be given a furlough.
The health district on Tuesday released public places the individual had visited last week, and encouraged people who were in those areas to watch for symptoms if they aren’t immunized. Qdoba confirmed that the individual works at its South Hill restaurant, and had worked a shift from 3 to 11 p.m. there on April 12. Symptoms could emerge as late as May 10.
The health district on Wednesday added one location to that list: the Subway at 905 S. Grand Blvd. from 3 to 11 p.m. on April 12. It was added because it shares a restroom with the Qdoba.
Health district officials still are trying to track down how the patient contracted measles. The individual, an adult who had not been vaccinated against the disease, has not been identified for privacy reasons.
McCullough said the health district is interviewing family members and close contacts of the person for clues to the exposure.
“It was either someone else in Spokane County who had the measles or someone traveling through Spokane County with measles,” McCullough said. The individual wasn’t traveling during the period when he or she would have been infected.
After news of the measles case broke Tuesday, Kim Papich, a health district spokeswoman, said she read social media accounts linking the case to a recent vaccination clinic in Spokane Public Schools. But that’s not medically possible, McCullough said.
“You can only catch measles from another person who is contagious with measles,” he said. “It’s not possible for the vaccine to transmit measles to the person being vaccinated, or for a person who was recently vaccinated to pass it onto another person.”
Last week, the health district offered vaccination clinics to children who didn’t have documentation of past immunizations filed with Spokane Public Schools, which is requiring that students show proof of vaccination or have their parents file exemptions. More than 400 vaccinations were given, including 67 protecting against measles.
There is no treatment for measles, and most people recover on their own. But severe complications can occur, including pneumonia and encephalitis, which is swelling of the brain.
If people without immunization are exposed to measles, a vaccination given within three days can prevent the illness or lessen its severity, McCullough said.
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