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The first case of measles in Shelby County has been confirmed by the Tennessee Department of Health.

The patient, a resident of Shelby County, is recovering at home, and public health officials are now working to identify any other persons who may have been exposed to the virus, the health department said.

Measles is a highly infectious respiratory virus that spreads through the air when an infected person coughs, talks or sneezes. Measles typically causes a red, spotty rash that starts on the face and spreads downward. Other symptoms can include fever, headache and fatigue and are often accompanied by red eyes and congestion.

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The Shelby County Health Department has activated its emergency plans and will contact any person who may have been exposed to the measles virus.

Dr. Nick Hysmith, head of the infectious disease division at Methodist Le Bonheur Healthcare, said it will be important to know the age of the patient and whether the person was vaccinated. 

“I think a lot depends on the details of the case as to what the response is going to look like,” Hysmith said, including if the patient is in a high-risk population – an area with a low vaccination rate, in a daycare setting or has a compromised immune system.

“Knowing where the case is and what population they are in, and if they had been traveling, those are huge pieces of information that will really shape what we do over the next several days and week,” he said.

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The first case of measles in Tennessee was confirmed March 21 in Middle Tennessee. Health officials have not released any information about the patient, except to say the person is recovering at home.

At this time, the Shelby County Health Department said the risk to the general public is low.

“I think these bodies will release information as soon as they can, particularly if there really is independent and unique action that needs to be taken,” said Dr. Stephen Threlkeld, director of infectious disease at Baptist Memorial Hospital & Health Care Services. 

“Rest assured, there will be more cases. We would be making a mistake only to worry about daycare if this happens to be a daycare case. I think we probably need to focus on doing all those things that are low-hanging fruit.”

That includes vaccination.

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“Check with your health care provider to determine your vaccination status,” said Dr. Michelle Taylor, the department’s director and health officer. “The measles, mumps and rubella vaccine, called MMR vaccine, provides the most effective protection available against measles when two doses are administered to children at the recommended ages of 12 to 15 months, with the second dose given at ages 4 to 6.”

Adults who were not vaccinated as children should get at least one dose of the MMR vaccine. Those at high risk because they work in education or health care should get two doses 28 days apart, the department said.

People unsure if they were vaccinated as children should ask their health care provider if they should be vaccinated now.

People in infectious disease, he said, are not surprised there is now a case in Shelby County.

“This intensifies our need to actually take action and just think about it,” Threlkeld said. “When a case is actually in the community, it’s time to learn about the disease, to be able to recognize the disease and take any steps that are appropriate to avoid it.”

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Shelby County has maintained at least a 95% MMR- immunization rate among kindergarten children for five years. But there are pockets in the city, often based on school attendance zones, where vaccination rates dip into the 70% range or lower.

Those areas are more prone to outbreaks, local physicians say. 

The vaccine now is given in two doses, which, when combined, provide 98% immunity. People who were born after 1957 but before 1989, when the CDC recommended the two-shot dose, usually got only one shot, which had an efficacy of 92%.

The change in dosage occurred because there were outbreaks in 1989, Threlkeld said.

“Those outbreaks show that the 92% efficacy of the one vaccine was not high enough to reach the 95% vaccination rate, which would be herd immunity,” he said.

In the early 1960s, the vaccine also was not a live, attenuated vaccine as it is now. People who believe they got the inactive vaccine should be revaccinated now, along with people who only got one dose.

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“We have plenty of vaccine at the present time, but there has been such an increase in demand that there may be some shortages developing here and there,” said Dr. Bill Schaffner, an infectious disease expert at Vanderbilt University.

“The companies say they’re working hard to keep up.”

People born before 1957 have little reason to worry, Schaffner said, because the disease is so contagious, “the chances are overwhelming that you acquired the measles infection.”

Hysmith is encouraged by the county’s high vaccination rates. 

“Everyone should remain vigilant,” he said. “I am hopeful that we can all come together as a community and get a handle on this. ... We should be able to put a stop to any ongoing outbreak pretty quickly.”