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Dental office among sites involved in measles cluster

January 24, 2019

By Jennifer Garvin

Dr. Lee
Dr. Lee

With measles in the news following reported outbreaks this month in the Northwest, the Centers for Disease Control and Prevention is currently featuring health care provider tips on its website and urging providers to report suspected cases to their local health departments within 24 hours.

Since Jan. 1, Clark County Public Health in Vancouver, Washington, has identified 35 confirmed cases of measles and 11 suspected cases, according to the department’s investigation posted on its website.

Officials at Multnomah County Health in Portland, Oregon, have also reported persons being exposed to measles, including one incident where “a person known to be contagious with the measles attended a Portland Trail Blazers basketball game” on Jan. 11.

Of the verified cases in Clark County, 25 were children under 10 years of age. Suspected areas of exposure include area churches, retail stores, medical offices, the Portland airport, and one report of a dental office in Battle Ground, Washington.

Measles is an acute viral respiratory illness. The first signs of the disease typically occur in the head and neck region and in the oral cavity.

According to Dr. Jessica Y. Lee, M.P.H., Ph.D., vice president and spokesperson for the American Academy of Pediatric Dentistry, common first signs of possible measles include malaise, slight fever and loss of appetite — all of which are consistent with a viral infection.

“There also may be some oral signs of an infectious disease, such as atypical gingivitis,” she said.

According to the CDC, patients are considered to be contagious from 4 days before, and to 4 days after the rash appears. The agency also said that 81 people brought measles to the U.S. from other countries in 2018 — the greatest number of imported cases since measles was eliminated from the U.S. in 2000.

Dr. Lee recommends that dentists follow all public health protocol if they suspect a patient has measles.

“As far as the dental office is concerned, most of your patients and staff will be protected if they are vaccinated,” Dr. Lee said.

“If you are located in an area where there is a higher nonvaccination rate, it may to be prudent to isolate the patient. The patient should be referred to their primary care physician for follow-up care. We should also note that infants may be too young to be vaccinated, so if infant patients are being seen, extra precautions should be taken to protect them from exposure or contact with the suspected measles patient.” (Infants brought along to the appointment of a parent or older sibling are also at risk.)

If the provider or staff have not been vaccinated against measles and suspect they were exposed to measles, the CDC recommends they get the MMR vaccine (measles, mumps and rubella) within 72 hours and immunoglobulin should be given within six days when available.

The ADA supports the use of vaccines to prevent disease.

In an April 2017 letter to the White House, the Association stressed that administering vaccines “is one of the most effective methods of preventing infectious diseases,” and noted that the widespread use of vaccines has eradicated smallpox and significantly reduced incidences of polio, measles, mumps, rubella, tetanus and a host of other preventable diseases.