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Patients in Washington state who visit The Vancouver Clinic are greeted with free face masks and pumps of hand sanitizer.

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A large sign outside urgent care alerts patients who have measles symptoms — say a runny nose or a high fever — to put on a mask before entering the waiting room.

“If you haven’t been immunized or don’t know, we’d like you to wear a mask,” said Marcia Sparling, the medical director at Vancouver Clinic.

The entrance to the Vancouver Clinic in Southwest Washington. Molly Solomon / OPB

Two of her facilities are among more than three dozen locations where people may have been exposed to measles. Other places include an Ikea, Costco and a Portland Trail Blazers game.

Sparling says the clinic recently created a measles task force that meets daily. Sometimes, doctors and nurses see patients in the parking lot to avoid contamination. They’re also asking patients with measles symptoms to come later in the day to avoid spreading the illness during busy hours.

Marcia Sparling is the medical director at The Vancouver Clinic, which has six locations in southwest Washington. Two of the facilities are among more than three dozen places where people may have been exposed to measles. Molly Solomon / OPB

“We’re trying to be as careful as we can because we'd like to try to shut down this infection chain,” Sparling said.

The outbreak started in Southwest Washington’s Clark County, but has been spreading. One case has been confirmed across the river in Portland and another has been identified in Seattle. Health officials say they suspect another case linked to the outbreak in Deschutes County.

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The viral illness is highly contagious and can remain in the air for up to two hours. Some 90 percent of people exposed to measles who have not been vaccinated will get it, said Clark County public health director Alan Melnick.

Dr. Alan Melnick is Clark County’s public health director. Molly Solomon / OPB

“We have an exquisitely contagious disease, that can be really severe and we have a prevention for it that's cheap, incredibly effective and incredibly safe,” he said. “We wouldn't be dealing with this if we had vaccination rates up.”

So far, 31 of the 35 confirmed patients in Clark County had not been vaccinated against measles. And the region has been identified by health experts as an anti-vaccination hot spot. Clark County’s vaccination rate is 78 percent, well below the 94 percent level necessary to protect people who can’t get vaccinated for medical reasons.

Melnick blames misinformation shared on social media for the area’s lower than normal rates.

“What keeps me up at night is worrying that we're going to have a child die from this, something that's completely preventable,” he said.

That’s a worry shared by many parents, especially those with newborn infants. The vaccine is generally not given to children younger than 1.

Vancouver resident Megan Jasurda hasn’t felt comfortable leaving the house with her son, 11-week-old Tristan.

“He’s on house arrest,” she said.

Vancouver, Wash. resident Megan Jasurda holds her 11-week old son, Tristan. During the measles outbreak, she hasn’t left the house with Tristan, who is too young to be vaccinated. Molly Solomon / OPB

Jasurda’s other two kids, who are 3 and 6, are both up to date on their shots, but she still has them wash their hands when they come home and change into new clothes before seeing Tristan.

“I think we gave into the fear right away because of having such a young child,” she said.

For now, her family is avoiding crowded areas and even decided to delay their daughter’s birthday party. She knows some people in her community choose not to vaccinate their kids, and she says it’s not worth putting her family at risk.