Photo by John Schreiber.
Photo by John Schreiber.

Two more cases of measles were confirmed in Orange County, bringing the tally to 20, Orange County Health Care Agency officials said Wednesday.

One of the patients visited Disneyland, where the outbreak was initially detected in December. It was unclear where the other person got the highly contagious virus characterized by skin rashes, according to Nicole Stanfield of the OC Health Care Agency.

So far, a dozen Orange County patients afflicted with measles have been determined to have visited Disneyland, she said.

Meanwhile, state health officials said there have been 59 measles cases confirmed in California, and 42 of them have been linked to Disneyland or Disney’s California Adventure.

On Tuesday, officials said five Disneyland employees were among an outbreak of measles patients — with three already healthy enough to return to work. One of those cases was a Disney employee who was diagnosed on Sunday, officials said.

The three people healthy enough to return to work were among those who contracted the virus in mid-December, officials said.

Across the state, the measles patients range in age from 11 months to 70 years old, according to state epidemiologist Gil Chavez. Six of the cases involve who are less than a year old and too young to get shots, he added.

One-quarter of the patients had to be hospitalized, Chavez said.

Cases connected to Disneyland have been confirmed in three Utah residents, two in Washington state, one in Oregon, one in Colorado and one in Mexico, Chavez said.

Chavez said the vast majority of the patients were never immunized with vaccines that are considered 99 percent effective.

State officials said children should get their first shots at 12 to 14 months, and a supplemental one before kindergarten.

Chavez and Kathleen Harriman, head of the California Department of Public Health’s Vaccine Preventable Disease Epidemiology Section, warned parents of infants younger than 1 to avoid large theme parks, such as Disneyland, or other gathering places attracting big crowds.

“People ask whether it is safe to visit venues where measles has been identified and the answer is yes, it is perfectly safe, as long as you have been immunized,” Chavez said.

Measles was thought to have been eradicated in California by the year 2000, with only a smattering of cases most every year since then due to international visitors, Chavez said. He said the low number of cases explains why there has been a delay in some cases of making the proper diagnosis.

“Health-care providers treating patients with a fever and rash should consider measles,” Chavez said.

In Orange County, one of the five children who have been diagnosed with measles had been vaccinated, but the four others had not, Stanfield said. She did not know if any the adults diagnosed with the virus had been immunized.

Orange County officials reiterated the importance of vaccines. Those who get sick despite getting vaccinated will only experience “mild illness” and are not likely to be contagious, Stanfield said.

Anyone who believes they have measles was urged to call their doctor’s office before going to be examined to prevent spreading the virus, which is contained in sneezes and coughs.

About two dozen unvaccinated students were sent home from Huntington Beach High School for three weeks.

A student with measles was on campus from Jan. 6 to Jan. 8, possibly spreading the contagious disease, according to a letter to parents from Matt Zahn, medical director for epidemiology at the Orange County Health Care Agency.

Students are expected to return to school Jan. 29.

State law requires schoolchildren to get the MMR shots to protect against measles, mumps and rubella. But parents who believe there are links between the vaccines and medical conditions such as autism can get an exemption by signing a personal belief waiver.

The link between autism and vaccinations has been widely rejected by a consensus of scientists.

Some adults, who may have gotten only one shot of vaccine, were encouraged to get another shot. A blood test can be done to determine if someone is immune to measles, Harriman said. The incubation period for measles can be up to three weeks, but those afflicted with the virus can still spread it without showing symptoms, she added.

City News Service

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