The threat has become a reality.
The first cases of measles in Salt Lake County in 1990 have been confirmed by officials of the Utah Department of Health, who are urging parents to have their children immunized.To accommodate working parents, local health departments Tuesday extended the hours of their immunization clinics, offering immunizations from 5-8 p.m.
Rick Crankshaw, coordinator of the Health Department's Immunization Program, said four cases of measles have been confirmed in Salt Lake County. Another case is "suspect."
As yet, health officials have been unable to determine the source of the outbreak.
But Crankshaw said all of the measles patients are preschool-age children, 18 months to 5 years old, and two were attending a preschool.
Four of the five children, suffering from high fevers, were seen at Primary Children's Medical Center, which causes health officials further concerns about the potential spread of the disease.
Last year Utah experienced the largest outbreak of red measles since 1976. There were 114 confirmed cases, and roughly 50 percent of them were in the preschool population. Twenty percent of them required hospitalization.
To avoid a repeat epidemic, the Salt Lake City/County Health Department has checked immunization records at the preschools attended by the infected children. Children who have not been immunized will be barred from attending the schools until they are vaccinated, or until the 14-day incubation period ends.
Additionally, the local health department is following up on every case, talking with parents to get names of anyone the infected children might have exposed. Those people also are urged to be immunized.
Infection control nurses at Primary Children's are working with the department in reporting and isolating cases as soon as they become aware of them.
"One of the problems with measles is the rash is the first symptom that the parents first think of as being measles. Even before the rash appears, the disease is the most infectious," Crankshaw said. "But parents think it's just a bad cold and let their children go out and infect other people."
Early symptoms of red measles include coldlike symptoms accompanied by a fever of at least 101 degrees. Only later does the red rash appear, usually on the face and then spreading to the extremities.
The disease is not just dangerous because of the high fever but because children with measles are particularly susceptible to pneumonia. Other complications include hearing disorders, convulsions and acute encephalitis.
Utah is at high risk for a measles outbreak _ primarily because several surrounding states, including Idaho, Colorado, Washington and California, have reported cases of measles.
California has had an ongoing outbreak since August 1987. Since the beginning of 1989, in Los Angeles County alone there have been 21 deaths due to measles. Yet many Utahns _ traveling back and forth from Utah to California _ have been lax about getting their own children immunized.
Since 1982, Utah has required immunizations for all children entering schools and licensed day-care centers. The diseases preventable through vaccine that are covered by the mandate are measles, rubella (German measles), mumps, polio, diphtheria, tetanus and pertussis (whooping cough).
Yet a survey for the 1988-89 school year revealed that just 93 percent of children in school, and only 87 percent of those in day-care centers, were adequately immunized.
"Low immunization levels contributed to last year's measles outbreak," Crankshaw said, and health officials have warned of possible continued problems in 1990.