This outbreak of Measles occurred in August of 2019. It all began on July 25th, when the
index patient spent a 5-6 day period with a sick child who had just returned from a Florida
vacation. The outbreak spread during a wedding the index patient attended on August 3rd. The
index patient was asymptomatic until the day after the wedding, August 4th, when she developed
tenderness in her left ear and jaw. On August 5th, her parotid salvatory glands were inflamed.
Four days after that, on August 9th, she went to seek medical attention. It was there that she was
diagnosed with Measles and treated.
Thirty-one of the individuals who attended the wedding contracted Measles from the
index patient. These cases are considered secondary because they came from their contact with
the primary source. Thirty of these patients contracted the virus after attending the wedding and
one after interacting with the index patient during a separate occasion. After the wedding, these
31 secondary patients went on to spread the virus to 27 tertiary patients who were diagnosed with
Measles after interacting with the patients who had attended the wedding/interacted with
secondary cases in Community A. These 27 tertiary patients developed parotitis on September
7th - September 23rd (35-51 days after the wedding). From these 27 tertiary patients, three
quarternary patients reported parotitis on September 26th - September 29th (54-57 days after the
wedding). All three of these patients could be linked to the tertiary patients and had contact with
them somehow. Since they contacted Measles from a tertiary patient, they are considered
quarternary patients.
The authors conclude that considering the index case, childhood measles vaccines can
wane in effectuality by adulthood. The majority of the infected patients had received their
vaccines but were also around 35 years old. This fits the theory that the vaccines’ effectiveness
waned after adulthood. This, along with the fact that viruses are known to mutate over time
explains how someone who was vaccinated can contract and spread Measles to other vaccinated
people.
When you compare the original date that the wedding occurred to the dates that the three
quaternary cases were reported, it shows that this virus’s spread slowed down significantly after
the tertiary cases. It also indicates that one point of Measles can continue to infect individuals
months after the index case. The quaternary patients were three people from the same
community, Community A. The spread was geographically prominent in this area due to the
majority of the secondary cases residing there. Although the cases begin to dwindle when
looking at the quaternary cases, the patients could have quickly spiked again without
intervention. If there were more secondary cases in another community, the outbreak could have
been a lot worse and been far more challenging to contain. The other eight states that had
attendants of the wedding were very few cases per state. This outbreak shows how bad one case
of Measles can spread and how much worse this situation could have been.