The second alert came in April, after routine wastewater testing in Lewes detected measles in a water sample.

“We were concerned that a measles case would pop up in Delaware, but that never happened. So we are making a guess that perhaps someone was traveling through the area. But again, if someone with measles travels through here, they could still potentially expose people that they come in contact with in Delaware.”

If a fully vaccinated person is exposed to measles, then visits or cares for an unvaccinated person, what’s the risk to the unvaccinated person?

Everything in the study of infectious diseases is a risk calculation, and a situation like that would be considered low risk. But “that is why vaccination is so important.”

What would you say to someone who is hesitant about vaccination?

“I cannot give a stronger recommendation for them, especially at this time. And I say especially at this time because every meeting I’m in, when I’m meeting with other states, when I’m attending national meetings, we’re always talking about measles.”

Given large-scale public events throughout the region this summer, such as the FIFA World Cup and American 250th anniversary events, “one of our biggest concerns is measles.”

My child isn’t old enough to be vaccinated. Are there common sense precautions I can take?

The first dose for infants is usually given between 12 and 15 months. Some states with outbreaks are recommending that babies get them earlier. Delaware is not one of them. However, it has long been recommended that a baby six months old or older who is planning to travel abroad get the measles vaccine.

“Be thoughtful about prevention and be really vigilant. If someone is telling you they’ve got a rash, they’ve got a cough, really try not to be around them. So often folks are like, ‘Oh, I can’t miss work,’ or ‘I don’t want to miss this playdate.’ But if someone’s sick, don’t bring your baby around.”

If I suspect myself or my child has measles, should I show up unannounced at a doctor’s office?

No. Call ahead and follow the health care facility’s instructions.

Are adults who were vaccinated decades ago still protected? 

If you were born before 1957, you are considered immune. If you were fully vaccinated, you’re also considered immune. If you’re concerned, however, your doctor can order a blood test to check for immunity. Such testing is fairly common.

“When we are doing a measles investigation, the first thing we ask is, ‘Are you vaccinated? Can you show us proof of vaccination?’ If we can’t find it in our Delaware database, then we ask people, ‘Can you show us your records?’ If people don’t have them, then we think about whether we need to recommend prophylaxis. But one of the steps in between is people will frequently go and have their (blood) drawn, which can demonstrate immunity.”

If a measles case is identified in Delaware, what happens next?

The process begins by identifying those who were exposed and inquiring about vaccine status. Then, health officials will “make appropriate recommendations about prophylaxis” – or a measure taken to prevent a disease from occurring before it becomes an active illness.

“We will also work with facilities depending on what type of facility it was. If it’s a hospital, we usually can get names and make phone calls to them. But sometimes it’s a public event, and we don’t have someone who can just give us all the names, so we will use social media and/or provide a letter that the facility can provide to inform people. I strongly encourage everyone to follow the Division of Public Health social media pages … We also strongly encourage health professionals, school leaders, business leaders, as appropriate, to sign up for our Delaware Health Alert notification, and that’s on our website.”