Buncombe County health officials confirmed three cases of measles and urged residents to verify their immunity and avoid exposing others while public health completes contact tracing. The county said all three cases are siblings living in the same household and that people who were in the Mission Hospital emergency department waiting room at 509 Biltmore Avenue in Asheville between 2:00 a.m. and 6:30 a.m. on Jan. 4 may have been exposed.

"We recently have 3 confirmed cases of measles here in Buncombe County. All are from siblings living in the same household," Stacy Wood, Buncombe County communications manager, said at the online briefing. Wood provided the county communicable disease line, (828) 250-6100, for anyone who believes they were present during the exposure window.

County doctors at the briefing described measles as a highly contagious airborne viral illness. "Most likely, 9 out of 10 people are going to get infected with the virus" if they are unvaccinated and exposed in a contained setting, one of the county clinicians said, noting the virus can remain in the air or on surfaces for up to two hours after an infected person leaves. Officials added infected people can be contagious about four days before a rash appears and for about four days afterward.

Health officials stressed the seriousness of the infection, particularly for young children. They said measles can cause high fever and respiratory complications; pneumonia is the most common cause of death related to measles, and about 1 in 1,000 children who contract measles can develop brain swelling that could result in seizures or long-term disability.

County staff reiterated that the MMR (measles, mumps, rubella) vaccine is the best protection. "The MMR vaccine is the most effective way to prevent getting measles," a county doctor said, and officials outlined routine dosing: the first valid dose at 12 months and a second dose between ages 4 and 6. They said an early dose (given at 6 months or older) may be considered only for infants at high risk because of travel or known outbreak exposure; an early dose does not count as the child’s routine first valid dose.

For adults, officials said one prior dose of a measles-containing vaccine generally indicates adequate protection, but people at higher risk — including international travelers and health care workers — should consider a second dose or check with their provider. County staff said people unsure of their records can request serology (titer) testing to confirm immunity or simply get vaccinated; the county immunization clinic can provide vaccines.

Buncombe County said it is working with the North Carolina Department of Health and Human Services on contact tracing and case investigation. Officials emphasized that Buncombe is not in outbreak status because the confirmed cases are confined to a single household and transmission was linked to travel associated with an outbreak in South Carolina. Still, they warned communities with pockets of under-vaccination are at higher risk if measles is introduced.

Officials advised anyone developing fever and rash to stay home, call their health care provider before visiting medical facilities to avoid exposing others, and call Buncombe County public health to be connected with a communicable disease nurse. The briefing closed with a reminder that the county immunization clinic can help residents check records and receive MMR vaccines.

There were no formal actions or votes taken at the briefing; county staff said they will continue case investigation and outreach to potentially exposed people and to local schools.

Contact: Buncombe County Communicable Disease Team, (828) 250-6100. For state guidance and the immunity checker, officials referenced the North Carolina Department of Health and Human Services measles resources.