A Massachusetts student exposed shoppers at the Kittery Outlet Malls to measles last week, prompting the Maine Center for Disease Control and Prevention to urge unvaccinated residents to watch for symptoms of the highly contagious illness.
The student, an unvaccinated individual originally from western Europe, visited the shops on April 20 while infectious with the virus, health officials said. Between noon and 3 p.m., the student stopped at several stores, including the Kittery Trading Post, Calvin Klein, Ralph Lauren and J. Crew.
The student was believed to be visiting Massachusetts as part of a short-term exchange program, according to Dr. Christopher Pezzullo, acting chief health officer of the Maine Department of Health and Human Services.
Massachusetts public health officials notified the Maine CDC of the issue late Tuesday, he said. Maine officials issued a news release and informed health providers through a statewide alert system on Wednesday afternoon.
While Maine CDC considers anyone visiting the shops during that time exposed to measles — which spreads through the air by coughing and sneezing — it has confirmed no new cases of the illness.
Maine’s last recorded case of measles was in 1997.
“Since measles is a contagious airborne disease, people who were at the Kittery malls from noon to 5 p.m. on April 20 should check their immunization records and be aware of the symptoms,’’ Pezzullo said in the news release.
The measles virus can survive for up to two hours in the air and on surfaces. The illness is so contagious that 90 percent of people who are not immune can catch it from being in close proximity to an infected person, according to the U.S. CDC.
People vaccinated against measles are unlikely to be affected, health officials said. Immunization is the best defense against the illness, according to infectious disease experts.
A widespread measles outbreak is unlikely, given high vaccination rates against the illness in Maine, Pezzullo said. Statewide, 91 percent of Maine’s population is immunized against measles, he said.
While most Maine residents have received a measles shot, vaccination rates are lower in pockets of the state and more parents are choosing to skip vaccines for their children. Just under 90 percent of Maine kindergartners were vaccinated against measles during the 2013-14 school year, according to federal data.
Measles symptoms include fever, cough, runny nose and red, watery eyes. A rash breaks out three to five days after symptoms appear, often beginning as flat red spots on the face at the hairline that spread down.
“Infected people are contagious from four days before their rash starts through four days after,” Pezzullo said. “As the exposure took place nine days ago, early treatments for those who may have been impacted is not effective. We recommend that a person with symptoms contact their primary care provider by phone to discuss treatment, as isolation to prevent the spread of measles may be necessary.”
Measles has no cure. Treatment involves rest, alleviating fever and other symptoms, supporting the immune system and consuming fluids to avoid dehydration. While most people recover from the illness, complications such as pneumonia and brain swelling can be life-threatening, according to the U.S. CDC.
If caught early, patients may receive a measles vaccine or injection of antibodies to stave off a full-blown infection and potentially ease symptoms.
“Most measles cases in this country have been among unvaccinated people and people with unknown vaccination status,” Pezzullo said. “This incident offers an opportunity to encourage people to know their vaccination status and to get vaccinated if necessary.”
Maine CDC’s warning comes in the wake of a measles outbreak that has sickened nearly 150 people in seven states since December, according to the U.S. CDC. Health officials suspect a traveler who became infected overseas spread the illness while visiting Disneyland in California.
One recent study attributed the rapid spread of the California outbreak to parents who refuse vaccines for their children.