Updated at 9:23 p.m. on Wednesday, April 24, 2019.
People who visited a Mapco convenience store on Browns Ferry Road in Chattanooga and a Chick-fil-A restaurant on Glenn Boulevard in Fort Payne, Alabama, on April 11 may have been exposed to measles, according to public health officials.
The Tennessee Department of Health and the Alabama Department of Public Health issued alerts Wednesday saying those who have not been vaccinated against measles and who visited the locations around the following times and for several hours afterward could be at risk: the Mapco at 200 Browns Ferry Road between 7:30 and 10 p.m. and the Chick-fil-A on 1824 Glenn Blvd. around 5:54 p.m.
"Most people in Tennessee are vaccinated against measles and are protected against this illness," said Dr. Tim Jones, state epidemiologist for the Tennessee Department of Health. "This appearance of measles is a reminder about the importance of vaccines in protecting our population, and we urge everyone who has not been vaccinated to do so now to protect themselves, their families, their coworkers and their communities."
Last week, health officials announced that one person from East Tennessee tested positive for measles — a highly contagious, viral infection that can cause serious illness in unvaccinated children. It's spread through the air when an infected person coughs, sneezes or breathes on another.
Officials are currently investigating that case and notifying people who may have been exposed to the virus through contact with the patient.
Tennessee's case is part of the largest measles outbreak in the United States since the disease was eliminated in 2000.
On Wednesday afternoon, the Centers for Disease Control and Prevention announced the outbreak had surpassed the previous largest outbreak since the disease's eradication in the U.S., with 695 cases in 22 states since January. The high number is fueled primarily by large outbreaks in Washington State and New York.
Mapco issued the following statement on Wednesday via spokeswoman Laura Guitar:
"The health of our guests is our highest priority. We have been notified by the Tennessee Department of Health that a guest who visited our Browns Ferry Road store on April 11 was diagnosed with measles. We maintain high cleanliness standards and follow industry best practices for sanitation. We will continue to support the Department of Health and wish a speedy recovery to our guest."
Officials said the infected Tennessee resident traveled through Alabama to East Tennessee from Mississippi on April 11. In addition to the above locations, they stopped at D & J Travel Plaza on 651 Highway 28 West in Livingston, Alabama, at 2:20 p.m.
On April 12, they stopped at a Speedway station at 2148 N. Charles G. Seivers Blvd. in Clinton, Tennessee. Individuals who visited that Speedway from 5:30 to 8 p.m. may also have been exposed, according to health officials.
There have been no other confirmed measles cases in Tennessee this year, and Alabama has no confirmed cases of measles.
Although there are no reported cases of measles currently in Alabama, department of public health spokesperson Dr. Karen Landers said the state issued an alert Wednesday "as an abundance of caution."
"We are working in cooperation with the Tennessee Department of Health, who actually called us and notified us that this case had come through Alabama," Landers said. "We are doing what we normally do, which is proactive surveillance."
Other states that have reported cases to CDC include Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, Oregon and Texas.
"We're very lucky that we only have one case now, and we're working really hard to keep the numbers low, but I would be very surprised if we don't have a few more cases, because it's such an easy disease to spread," Jones said.
State efforts to combat the disease include informing the public about vaccine prevention and aggressively tracking down potentially exposed individuals.
"Far and away the best way to prevent measles is appropriate vaccination," Jones said. "Our immunization rates in Tennessee are quite high. We're certainly in the middle of the pack nationally, so that doesn't put us at higher risk than other states."
Health officials said only 15 other cases have been diagnosed in the state in the last decade. The largest and most recent outbreak consisted of seven cases in Shelby County in 2016.
However, Jones said nationally and internationally the rates of unvaccinated people is growing, which poses a particular threat to people with medical conditions that keep them from being immunized.
"If unvaccinated people get measles, they have the potential to spread it to people around them, including babies who can't be vaccinated yet, people with immunosuppressive conditions — people who don't have a choice," he said.
Although measles typically comes into the U.S. from other countries, the current outbreak means it's now possible to acquire the disease in outbreak states.
Jones said there is no debate within the medical and scientific community as to whether the measles vaccine is safe, despite what people may read on the internet.
"Social media allows anyone to put out messages, and information travels fast, which means sometimes untrue messages spread," he said. "It's important for people to get their health information from reliable medical professionals."
Measles vaccines given to unvaccinated persons within 72 hours of exposure can prevent disease. It's also appropriate for any unvaccinated person to receive the measles-mumps-rubella vaccine (MMR) regardless of time of exposure.
The Tennessee Department of Health recommends anyone who visited these locations during the specified times on April 11 or 12 to do the following:
Check your vaccination status. Locate your immunization records. People who have had two doses of the measles-mumps-rubella vaccine are protected against measles and need to take no further action in regard to an exposure to measles. Contact your health care provider if you cannot locate your immunization records and/or are not certain if you are immune to measles.
If you are not immune to measles, watch for symptoms of the illness. Measles symptoms may include fever, runny nose, body aches, watery eyes and white spots in the mouth. Several days after these symptoms start, a red, spotty rash typically begins on the face and spreads over the body. Symptoms may develop any time in the 21 days after exposure to the illness. Nearly one in three measles patients will develop ear infections, diarrhea or pneumonia.
If you develop measles symptoms, stay home and contact your health care provider. Those with symptoms of measles should call a health care provider before going to a health care center in order to prevent further exposure of others to the illness.
People with questions about what to do to protect themselves against measles should call a health care provider, the local health department or a hotline established to provide answers to questions from the public about measles. The hotline number is 865-549-5343, and calls to it will be answered from 7 a.m. to 3:30 p.m. CST and 8 a.m. to 4:30 p.m. EST daily until further notice.
More information is available on the department of health's website.
Contact staff writer Elizabeth Fite at firstname.lastname@example.org or 423-757-6673.