Florence, AZ – Pinal County Public Health officials are announcing the
successful containment of measles to just one case in Pinal County. On May 15,
2008, Pinal County identified a case of measles in an unvaccinated child living
in the San Manuel area. The child has now fully recovered.
It is believed this case is associated with the outbreak of measles that is
ongoing in southern Arizona. By late June, two full incubation periods had
elapsed since the case, making it possible to declare the county free of
measles.
There was just one confirmed case of measles in Pinal County,said Pinal County
Public Health Director Tom Schryer. Our Public Health staff deserves credit for
successfully containing this to one case by being thorough and proactive.
Numerous other suspects were ruled out as not having measles, according to
Schryer. Fewer than ten individuals had symptoms suspicious enough to result in
additional testing. He added that there are currently no suspected cases under
investigation at this time in Pinal County.
In July 2007, the Pinal County Board of Supervisors approved the formation of
the Pinal County Public Health District, which enabled the Health & Human
Services Division to build a more robust, proactive public health program.
What did Pinal County do to investigate the case?
Pinal County Infectious Diseases and Epidemiology was notified by the Arizona
Department of Health Services (ADHS) about a positive lab result in a child who
had symptoms consistent with measles. The child had been seen in a hospital in
Tucson where specimens had been pulled for testing.
Pinal County immediately started a contact investigation to identify anyone who
might have been exposed and could be at risk of contracting disease.
Health officials contacted the child’s mother and interviewed her about
everywhere the child had been while infectious. They identified 55 people who
had contact with the child while it was infectious. Calls were placed to all
people identified as exposed to inform them, provide information on measles,
answer questions and inquire about immunization status. A standardized
questionnaire is used when interviewing contacts. The initial call and interview
usually takes between 20 and 30 minutes. If someone was not immunized or could
not produce proof of immunization, the county offered free immunization through
its public health clinics. A total of 20 vaccinations were provided to
identified contacts, Contacts were instructed to watch for symptoms and contact
Pinal County Public Health if they developed any symptoms. They were also told
to stay home if a fever developed to ensure that secondary spread did not
occur.Daily calls were made for 21 days after exposure to any previously
unvaccinated contacts to make sure they remained asymptomatic. At 21 days after
exposure, all contacts were called again to make sure they never developed
symptoms and to inform them that the incubation period was over.No additional
cases or secondary spread have been identified.
How did Pinal County stop spread of this disease?
Multiple control measures are used by the County to prevent the spread of
infectious diseases:
Public Health officials perform a “contact investigation” to identify
individuals who may have had contact with the infected person. They may be at
risk of contracting the infection so officials attempt to keep them from getting
sick, and if they do get sick, ensure that they don’t expose others. Time is
critical with the contact investigation. Pinal County had identified and
contacted all exposed individuals within 72 hours after notification of the
case. Pinal County recommended an accelerated measles vaccination schedule for
children as soon as the case was identified., Public Health representatives
called local clinics, urgent care facilities and emergency departments to inform
them of the situation, provided information on measles and accelerated
vaccination, and asked them to be on the lookout and to call in anything
suspicious. This ensures that the County can identify any new cases or suspects
quickly and to make sure that cases are not being missed. Pinal County provided
information to the public through the county’s hotline and Citizen Contact
Center, website and through the news media. After cases were found in Pima
County, Public Health verified immunity to measles for designated county staff
in the event that Pinal County would have an infected resident.
Why is measles a big deal? Why do you vaccinate?
Measles is one of the most contagious diseases that we know of. It is spread
through the air, primarily from an infected person coughing, and can linger in
the environment for hours. While most infections are uncomplicated, it can
potentially be very serious and cause pneumonia, blindness, encephalitis and,
rarely, death. Measles will kill between 2 and 3 of every 1000 people that
contract the disease. Vaccination has greatly reduced the number of cases
occurring in the United States since its inception.
How do you handle a suspected or possible case?
When a physician, school official, resident or others call suspecting measles,
Public Health officials evaluate the symptoms to determine if they are
consistent with measles. If symptoms are suspicious of measles, a field team
from the infectious diseases section is sent out to evaluate symptoms firsthand,
interview the family and draw specimens for testing. Each suspect is evaluated
using symptoms and lab testing to determine if it is a case.
How many shots were given at county clinics?
Since May 1, Pinal County Public Health has provided over 400 doses of the MMR
vaccine to residents through our public health clinics.
How many people worked on this investigation?
Many county employees were involved in the response to this measles case. The
infectious diseases and epidemiology section performed the contact
investigation, coordinated immunization for contacts, implemented control
measures, and investigated other reports of rash illness in the county. Pinal
County staff also routinely consulted with ADHS concerning the situation.
Clinic staff provided vaccination to identified contacts and to others that came
to public health clinics for immunizations. Public health preparedness staff
facilitated communication within the county and to the public. Staff from the
Pinal County Citizen Contact Center took calls from the public, answered
questions and routed calls with specific questions to the appropriate people.
When should children be vaccinated?
Since there has been no secondary transmission of measles in the county, Pinal
County is now recommending returning to a routine childhood vaccination
schedule. This means that a child should get the first dose of MMR as soon as
possible after their first birthday. A second dose should be administered before
beginning school.
For information on immunizations or the locations of Pinal County Public Health
clinics, call 520-509-3555 or 888-431-1311.
Comments from the Board of Supervisors
Chairman David Snider, District 3 Supervisor: The successful effort to control
and mitigate this outbreak of measles is not only critical to our continuous
campaign to support the health and well-being of our residents, it’s also an
investment in our economic well-being. Healthy residents are able to go to work
on a daily basis, attend our educational institutions, and pursue their normal
lives without fear of epidemic or contagious diseases. I want to thank and
congratulate all of the health care providers that worked tirelessly to make
sure that there was no spread of measles beyond the unfortunate single case.
Supervisor Lionel Ruiz, District 1 Supervisor: The cooperation of the family,
the general public, state health officials and the medical contributed to a
successful outcome. I am pleased that the young child with measles has recovered
from the illness and no other children or adults were affected.
Supervisor Sandie Smith, District 2 Supervisor: “This situation underscores the
reasons we created the Public Health District with the goal of increasing the
number of fully-immunized children. Vaccinating your child protects against
serious and deadly diseases and prevents the spread of preventable diseases.
