California public health officials say unvaccinated people and children too young to be immunized against measles should avoid Disneyland after new infections were linked to the theme park.
The cases are the latest in an outbreak that began in late December that has sickened 59 people in the state. San Diego County health officials have so far reported 13 cases in the region.
The advice came after health officials reported new cases linked to Disney in January. A total of 42 cases have been traced to the park in Anaheim.
Across the state, the measles patients range in age from 11 months to 70 years old, according to state epidemiologist Gil Chavez. Six of the cases involve who are less than a year old and too young to get shots, he added.
One-quarter of the patients had to be hospitalized, Chavez said.
Cases connected to Disneyland have been confirmed in three Utah residents, two in Washington state, one in Oregon, one in Colorado and one in Mexico, Chavez said.
Chavez said the vast majority of the patients were never immunized with vaccines that are considered 99 percent effective.
State officials said children should get their first shots at 12 to 14 months, and a supplemental one before kindergarten.
Chavez and Kathleen Harriman, head of the California Department of Public Health's Vaccine Preventable Disease Epidemiology Section, warned parents of infants younger than 1 to avoid large theme parks, such as Disneyland, or other gathering places attracting big crowds.
"People ask whether it is safe to visit venues where measles has been identified and the answer is yes, it is perfectly safe, as long as you have been immunized," Chavez said.
Measles was thought to have been eradicated in California by the year 2000, with only a smattering of cases most every year since then due to international visitors, Chavez said. He said the low number of cases explains why there has been a delay in some cases of making the proper diagnosis.
"Health-care providers treating patients with a fever and rash should consider measles," Chavez said.
Anyone who believes they have measles was urged to call their doctor's office before going to be examined to prevent spreading the virus, which is contained in sneezes and coughs.
State law requires schoolchildren to get the MMR shots to protect against measles, mumps and rubella. But parents who believe there are links between the vaccines and medical conditions such as autism can get an exemption by signing a personal belief waiver.
The link between autism and vaccinations has been widely rejected by a consensus of scientists.
Some adults, who may have gotten only one shot of vaccine, were encouraged to get another shot. A blood test can be done to determine if someone is immune to measles, Harriman said. The incubation period for measles can be up to three weeks, but those afflicted with the virus can still spread it without showing symptoms, she added.
