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Action: The Snohomish Health District Health Officer Dr. Mark Beatty sends alerts via email to local health care providers. Alerts cover current local, regional or national health threats and important updates on medical care and protocols. Alerts are written as needed to cover urgent or emergent health issues.


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Primary Measles Infection in Snohomish County — July 7, 2018

Action requested:

  • Be aware that a single case of laboratory-confirmed primary measles has been identified in one member of a large group of foreign minors visiting multiple states in the U.S. for a summer program. No cases of measles have been linked to the current patient.
  • The minor with measles visited the following locations at the following times:
  • June 20: Walmart, 19191 N Kelsey St, Monroe from 2 - 10 pm
  • June 21: McDonald's, 19515 State Hwy 2, Monroe from 9 am - 2 pm
  • June 21: Dairy Queen, 19510 US-2, Monroe from 9 am - 2 pm
  • June 21: YMCA pool, 14033 Fryelands Blvd, Monroe from 10 am - 6 pm
  • June 22: Providence Regional Medical Center Everett, 1700 13th St, Everett from 3 - 9 pm
  • June 22: Wendy's 2510 Broadway, Everett from 5 - 10 pm
  • June 23: Providence Regional Medical Center Everett, 1700 13th St, Everett from 3 - 9 pm
  • June 24: Providence - Monroe Clinic Pharmacy, 19200 North Kelsey Street, Monroe
  • June 27: Swedish Redmond Clinic, 18100 NE Union Hill Rd #200, Redmond from 11:30 am – 5:00 pm
  • June 27: Providence - Monroe Laboratory, 19200 N Kelsey St, Monroe from 1 pm – 5:30 pm
  • Staff and customers may have been exposed to measles at the following dates and locations.
  • Consider measles in patients with compatible symptoms AND a possible exposure on the dates and locations described.
  • Take a travel history on all patients presenting with symptoms consistent with measles at every visit. Currently, measles cases in at least two states have been associated with exposure in the Ukraine.
  • Symptoms consistent with measles are:
    • Fever measured above 101 F
    • Full body maculopapular rash
    • Injected conjunctiva (red eyes without discharge)
    • Clear nasal discharge (coryza) with/without other upper respiratory symptoms (cough etc.)
    • White patches in the posterior oral mucosa a few mm in diameter (Koplik spots)
  • Symptoms typically start 7 to 21 days after contact with an infectious case. Early symptoms of measles typically include high fever, runny nose, cough and malaise; however rash typically starts on the head and spreads to the full body in the unvaccinated.
  • If a person has symptoms of measles and has had a possible exposure at the places and dates listed, isolate him/her from other patients and notify the Snohomish Health District immediately for assistance with prompt diagnostic testing.


Measles is a highly contagious respiratory viral disease that spreads easily when the infected person breathes, coughs, or sneezes. You can catch measles just by being in a room where a person with measles has been. The virus remains in the air up to two hours even after that person is gone. All persons who are exposed to the virus and have not been immunized against measles will most likely get the disease.

Measles is especially dangerous for children under 12 months of age, pregnant women, and immunocompromised persons. The best protection against measles is the MMR vaccine, usually administered to children at 12-15 months old and at 4-6 years old.

To be considered immune, a person should have two documented doses of the MMR vaccine. Most adults born before 1957 had measles and are considered to be immune.  Adults born in and after 1957 should have had at least one dose of MMR or have evidence of immunity.


Measles Assessment Checklist for Providers (Word)



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Health alerts include information about diseases or other health risks or issues that affect Snohomish County.