A Franklin County resident has become the third confirmed Missouri measles case tied to an Amtrak trip from Sedalia to Chicago, and health officials are asking anyone who visited several St. Louis-area businesses, including Busch Stadium, to watch for symptoms into early October, St. Louis Public Radio reported on Sept. 23.
The possible exposures happened from Sept. 12 through Sept. 14 at a ballgame, bars, restaurants and markets in St. Louis, Pacific and Chesterfield. Because measles symptoms can take up to 21 days to appear, the monitoring window for the last listed site runs through Oct. 5.
Local officials stress that this is not an outbreak. But the chain shows how one exposure on a crowded train can reach a stadium section, a neighborhood bar and a grocery store in another county within a few weeks.
Three Cases, One Train and a Weekend of Exposures
The chain traces to Aug. 27, when a person with measles boarded Amtrak Train 318 in Sedalia bound for Chicago. Health officials have since confirmed cases in residents of Jackson County, St. Louis County and Franklin County. The St. Louis County case was the county's first in about 20 years. Kansas City-area reporting has also described a household case connected to the same traveler, KRCG reported, so counts of train-linked cases vary by source.
Vaccination did not fully prevent these infections. The Jackson County and St. Louis County patients were fully vaccinated, and the Franklin County resident had received one of two recommended MMR doses, St. Louis County Health Director Dr. Kanika Cunningham told First Alert 4. Two doses are about 97% effective, and vaccinated people who do get sick usually have milder illness.
The Missouri Department of Health and Senior Services released the Franklin County patients' locations on Sept. 21, St. Louis Public Radio reported. Each window includes two extra hours because the virus can linger after an infected person leaves.
On Saturday, Sept. 12, possible exposures occurred at The Cat's Meow in Soulard from 3:30 p.m. to 7:50 p.m., at Busch Stadium in Section 141 from 6 p.m. to 11:30 p.m., and at Paddy O's downtown from 9:30 p.m. until closing. On Sunday, Sept. 13, the list includes Little Ireland in Pacific starting at 11:30 a.m., B&H Market in Pacific starting at 6:30 p.m., and Pacific Brew Haus from 8 p.m. until closing. On Monday, Sept. 14, it includes Goodcents in Chesterfield from 3 p.m. to 5:15 p.m., and Bud's Market in Pacific from 5:30 p.m. to 7:45 p.m. Street addresses are listed in FOX 2's report.
Officials Say Watch Closely but Do Not Panic
"There are some pockets of individuals who you know are unvaccinated, but right now we're not seeing this as an outbreak," Cunningham said. "We're monitoring every day."
Franklin County Health Director Tony Buel said he had not heard of the resident spreading the virus to anyone else. "But keep in mind onset can be as long as 21 days," he said.
State officials are more cautious about the train itself. Nathan Koffarnus, assistant communicable disease chief at the state health department, said the infected rider had prolonged, close contact with others. "Those cars can be pretty full, and people are in close quarters for a prolonged period of time," he said.
The local backdrop matters. About 89.5% of Missouri kindergartners received the MMR vaccine in the most recent data, below the 95% level needed to keep measles from spreading. Missouri has logged 10 measles cases this year, according to the CDC's measles tracker, as national cases near 3,500, the most in decades.
Families Who Were at the Listed Sites
Risk is highest for unvaccinated people, babies too young for their first MMR dose, pregnant people without immunity, and anyone with a weakened immune system. For them, a few hours in the same bar or stadium section can be enough, since measles spreads through the air and can remain for up to two hours after an infected person leaves.
Anyone who was at a listed location during the posted times should first check vaccination records. Adults who cannot find records, or who have had only one dose, can ask a clinician or pharmacist about a blood test or a catch-up shot. "If you were at these places, check your vaccination status," Cunningham said. "If you're unvaccinated, quarantine, call your doctor, let them know, monitor for symptoms."
Symptoms usually begin 7 to 14 days after exposure but can appear up to 21 days later. Early signs include fever, cough, runny nose, and red, watery eyes, followed a few days later by a rash that starts at the hairline and spreads downward. Anyone who develops these symptoms should call a doctor or urgent care before arriving so staff can protect others in the waiting room. Trouble breathing, confusion, seizures, or signs of dehydration in a child need emergency care.
Most people at these sites only need to check their records. Fully vaccinated people are unlikely to become seriously ill, and there is no need to avoid public places in the St. Louis area. MMR shots are available through pediatricians, pharmacies, county health departments, and the federal Vaccines for Children program for eligible children.
The next key date is Oct. 5, when the 21-day window for the last listed exposure closes. MedicalDaily will track any new cases and exposure notices from state and county health departments.
This is a small, traceable cluster, not an outbreak. Anyone who was in Section 141 at Busch Stadium or at the other listed sites during those hours should check their MMR status now and watch for symptoms through early October.
Key Questions Answered
How are the Missouri measles cases connected?
Cases in Jackson, St. Louis, and Franklin counties have been tied to an infectious traveler who boarded Amtrak Train 318 in Sedalia on Aug. 27, bound for Chicago.
Where were people possibly exposed in the St. Louis area?
Sites include Busch Stadium Section 141, The Cat's Meow and Paddy O's on Sept. 12; Little Ireland, B&H Market and Pacific Brew Haus in Pacific on Sept. 13; and Goodcents in Chesterfield and Bud's Market in Pacific on Sept. 14.
How long should exposed people watch for symptoms?
Health officials advise watching for 21 days after exposure. For the last listed site, that window ends Oct. 5.
Can vaccinated people still get measles?
Rarely. Two of the three Missouri patients were fully vaccinated, but two MMR doses are still about 97% effective, and breakthrough illness is usually milder.
What should someone do if they develop symptoms?
Call a doctor or urgent care before going in so staff can prevent exposing others. Seek
Published by Medicaldaily.com
