Health officials are on alert after an adult with measles went to a Berkeley restaurant last Friday, as the number of cases in the California-centered measles outbreak climbed to at least 156 patients across eight states, Canada and Mexico.
Those who went to the La Mediterranee restaurant in Berkeley between 6:45 and 10 p.m. on Feb. 20 could have been exposed to the measles.
“The risk is very slight for those who have received the recommended two doses of the vaccine,” Berkeley health officials said.
The restaurant patron, a San Mateo County resident, was infectious but unaware at the time because the tell-tale rash had not yet appeared. Health officials are working with the restaurant to assess employees who may have been exposed, as well as other individuals who may have come in close contact with the patient.
Of the 130 cases now confirmed in California, at least 40 have been directly linked to visitors or employees at Disneyland during the holidays; 30 were family members or people who came in close contact with someone who had the measles. And at least 10 caught the measles by being in a public area such as an emergency room where a confirmed case was known to be present, officials said.
The particular measles virus found in most of the California cases, known as B3, shares the same genetic material as the type most commonly found in the Philippines, according to lab tests of the virus in at least 51 cases.
Two other types of measles, D8 and D4, have also been detected in at least three recent patients, indicating that new introductions of measles have also occurred in California, according to the state department of public health.
Officials emphasized that these three types of measles could have come from a traveler from any number of countries. B3, the type of measles found in the Philippines, has been present in at least 14 other countries as well as six other American states. D8 has also circulated in countries such as France, Belgium, Chile, Canada, India, Singapore and Vietnam, according to the U.S. Centers for Disease Control and Prevention.
The CDC has issued measles travel advisories for both the Philippines and Vietnam. Vietnam recorded more than 18,000 measles cases in 2014, and the Philippines, more than 50,000 illnesses and 110 deaths.
More information on recommended vaccinations before travel can be found on the CDC website.
Cases connected to the California-centered outbreak also have been confirmed in at least seven other states: Arizona (five), Utah (three), Washington (two), Michigan (one), Oregon (one), Colorado (one) and Nebraska (one) -- as well as Canada (10) and Mexico (two).
Twelve counties in California have confirmed measles cases: Alameda, Contra Costa, Los Angeles, Marin, Orange, Riverside, San Bernardino, San Diego, San Mateo, Santa Clara, Solano and Ventura.
Orange County has 35 confirmed cases. Los Angeles County follows with 32 cases, San Diego County with 14 and Ventura with 12.
About 57% of the measles cases were adults 20 years or older. About 12% were infants less than a year old.
Federal recommendations call for the first dose of measles vaccination, known as MMR, to be given at 12 to 15 months of age, with a second dose between ages 4 and 6. California law requires two doses of the measles vaccination before kindergartners can enroll, but parents may obtain exemptions for the vaccines if they say the inoculations conflict with their personal beliefs.
Of the California patients who had vaccination records, 55 of them were unvaccinated, and 17 had one or more doses of the measles vaccine, officials said Friday.
Symptoms of measles include fever as high as 105 degrees Fahrenheit, cough, runny nose, redness of eyes, and a rash that begins at the head and spreads to the rest of the body. It can lead to inflammation of the brain, pneumonia and death.
Those who suspect they have the measles are urged to first call their healthcare provider before going to a clinic, enabling caregivers to make special preparations so patients don’t risk infecting others in the waiting room.