We’ve told you recently about outbreaks of vaccine-preventable disease in communities that are loath to line up for immunizations. Unfortunately, that trend is continuing as a rapidly expanding rash of measles cases has moved health officials in Clark County, WA to declare a public health emergency. The first reported case was tracked back to a single person at nearby Portland (OR) International Airport on January 7. Four days later, a second infected person attended a Portland Trailblazers basketball game. By January 22, there were 23 confirmed cases and two suspected cases among people who had reported visiting high-volume locations like schools, churches, a dentist’s office, and various retail establishments. The majority of the confirmed cases occurred in individuals who have not been immunized against measles. The fear now is that the outbreak will grow; Clark County officially declared an emergency in light of the fact that 7.9% percent of children there got exemptions from measles vaccine. Of note, only 1.2% were for medical reasons. The rest were exempted due to personal or religious reasons. Of the cases already confirmed, 18 are in patients between 1 and 10 years of age. Remind patients that measles has become a rarity specifically because of immunization, and that declining protection leaves them and those around them at risk. Read more about this issue from an urgent care perspective in Unexpected Viral Illness in an Urgent Care Setting: The Re-Emergence of Mumps, Measles, and Varicella, in the JUCM archives.