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Traveler with contagious measles case may have exposed public at Tucson airport

A visitor to Tucson may have exposed the public to an active case of measles at Tucson International Airport on Monday, officials warned.

An out-of-state traveler with measles visited Tucson between April 17 and 29, and passed through the airport Monday morning, the Arizona Department of Health Services and Pima County Health Department said Wednesday.

The individual was "potentially contagious" and was at TIA sometime before 10:40 a.m. Monday, officials said. The airport is the only location where the public may have been exposed that officials are aware of presently.

Severe cases of measles can result in deafness, blindness and brain damage, health officials have cautioned. Despite unfounded claims that some have tied to the increasing numbers of people who are not vaccinated against measles and other diseases, there are no scientific studies showing a connection between immunizations and autism.

"Measles is a serious and highly contagious disease that can spread quickly, so if you or your child are not vaccinated against the disease and you were at the Tucson International Airport, there is a risk of getting measles," said Dr. Cara Christ, director of the state health agency. "If you develop signs of measles, including high fever, cough, runny nose, red watery eyes, or a rash, stay home and call your healthcare provider so you can schedule a time to be seen. They will let you know when to visit their office so as not to expose others in the waiting area. If you do not have a health care provider, you may need to be seen at your local hospital emergency room or urgent care center. Please call before going to let them know you may have measles."

Measles spreads through the air when an infected person coughs or sneezes, officials said. Measles symptoms appear seven to 12 days after exposure but may take up to 21 days to appear. It begins with fever (101 degrees F or higher), red, watery eyes, cough and runny nose and is followed by a rash that is red, raised, and blotchy. The rash begins on the face at the hairline and moves down the body and may last five to six days.

Measles is highly contagious, with 1 in 4 people hospitalized, according to a New York state study.

"If you are in a room of 10 people who are unvaccinated against measles and someone with measles walks in, nine of those 10 people are going to get sick," said Jessica Rigler, assistant director for public health preparedness for the Arizona agency.

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"We are working closely with local, state and out-of-state public health partners to make sure we quickly identify any possible exposures that may have occurred while this person was visiting Pima County," said Marcy Flanagan, director of the Pima County Health Department. "As we see more cities and counties in the United States experience cases of vaccine preventable diseases like measles, it is of the upmost importance that we continue our work to prevent that from happening in Pima County."

Last month, ADHS warned that increased exemptions from vaccines are putting the state at risk this year for an outbreak of measles, mumps and other preventable diseases. In March, officials announced that a 12-month-old in Pima County, who had traveled in Asia, had been diagnosed with measles.

Measles can be prevented with the MMR vaccine. The vaccine protects against three diseases: measles, mumps, and rubella. The CDC recommends children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age and the second dose at 4 through 6 years of age. Teens and adults should also be up to date on their MMR vaccination. The MMR vaccine is very safe and effective. 

You are immune to measles if you have received two doses of the MMR vaccines or were born before 1957 and have received one MMR vaccine, officials said. Health care providers are required to report suspected cases of measles to their local health department.

Immunization information is reported for three grade levels of children, but the health department uses the kindergarten coverage rate for measles, mumps and rubella (MMR) to indicate how protected an area is from those diseases. Officials consider the general threshold of immunity for such preventable diseases as 95 percent in a community, providing herd immunity from the spread of a disease.

“When we see coverage dipping below 95 percent for that vaccine, we know that Arizona is at a risk for measles outbreak specifically, and that certainly is one of the most severe diseases that we track,” said Jessica Rigler, assistant director for public health preparedness for the health services agency.

The MMR kindergarten immunization rate fell to 93 percent this year. In northern counties with historically high personal exemption numbers, that rate is much lower. Only 83 percent of kindergarteners are vaccinated for MMR in Yavapai County, according to health services data.

Arizona is one of 17 states that allow personal exemptions to vaccinations. Vaccines are mandatory for all grade levels, but DHS only requires schools to report immunization rates for students in preschool, kindergarten and sixth grade unless a doctor exempts them because of medical reasons or a parent exempts them because of personal, philosophical or moral objections.

"Anti-vax" opponents of immunizations have spread numerous conspiracist fantasies, claiming harm from routine vaccinations.

In 1998, The Lancet medical journal published a study linking certain vaccinations to autism, triggering the anti-vaccination movement. The study was later retracted after it was found the doctor who led the study falsified the data and his claims were fraudulent.

Will Humble, executive director for the Arizona Public Health Association, said vaccination rates are becoming worrisome.

“I just don’t see any other alternative than to get rid of the personal exemption,” he said.

ADHS reports 60 percent of counties in Arizona are now at risk for a measles outbreak. Only 4 out of 10 kindergartens are above the threshold to be considered immune.

A 2018 study identified Phoenix as a “hotspot” for potential disease outbreak because of the high rate of parents who opt out of vaccinating their children.

In Maricopa County, nearly 3,000 enrolling kindergartners had non-medical exemptions from vaccination in the 2016-17 school year, according to the study. That’s three times as many unvaccinated kindergartners as the next-highest county, Salt Lake County in Utah.

Measles is considered to be eradicated from the U.S., classifying it as an imported disease. People who get the disease often get it from visitors who have traveled here from other countries or from traveling internationally.

Alexandra Bhatti, faculty associate in Arizona State University’s College of Health Solutions, told ASU Now last year that “before the middle of the last century, diseases like whooping cough, polio, measles, Haemophilus influenzae and rubella struck hundreds of thousands of infants, children and adults in the United States. Thousands died every year from them.”

But as people began using vaccines for these diseases, their rates declined.

However, outbreaks still occur – even when vaccines are readily available.

A measles outbreak hit Maricopa and Pinal counties in 2016, infecting about a dozen people. The outbreak – one of the largest outbreaks in years – started at a privately run detention center in Eloy.

The potential spread of illness is not the only result of non-vaccination.

“You also have the effect on the health-care system,” Daniel Crawford, a clinical assistant professor in the College of Nursing and Health Innovation at Arizona State University, said last year. “And so that utilizes more health-care resources and increases the amount of money spent in the community.”

For information about measles, visit the Arizona Department of Health Services’ website at azhealth.gov/measles.

Cronkite News reporters Veronica Graff, Amanda Fahey & Nicole Hernandez contributed background to this report.


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CDC

This photo from the 1960s shows a child with measles. Vaccinations have largely controlled measles and many other diseases, but recent cases and exposures in Arizona have put those who aren’t vaccinated at risk.

Measles symptoms

  • Typically appear 7-12 days after exposure but may take up to 21 days.
  • Begin with fever of 101 or higher, red, watery eyes, cough and runny nose.
  • Followed by a red, raised and blotchy rash that begins on the face at the hairline and moves down the body.

Source: Maricopa County Department of Health