Health officials will know by this weekend if the measles outbreak in Davis County - now pegged at 45 cases - has been contained.

Dr. E. Arnold Isaacson, who has been on the job as health department director just one week, told the county health board Tuesday that "walking into a measles epidemic was like walking into a buzzsaw."Nursing director Mary Meredith said her staff has been stretched to its limit, conducting extra immunization clinics, researching school immunization records and tracking the outbreak through local doctors.

Isaacson has used the county's graphics department to prepare a map of the outbreak, which is concentrated in the Layton area but is countywide.

Based on the 14-day incubation period of measles, Isaacson told the board that if the number of cases begins to taper off by the end of the week, the epidemic may have been contained.

The county's strategy is to "ring" victims, Isaacson said. That involves isolating the victim, preferably at home, and ringing them with persons who have been immunized to prevent the disease from spreading.

Meredith said 45 cases are now confirmed in Davis County, with two or three pending confirmation through blood tests. Victims range in age from under 15 months, the age of the first immunization, through a 45-year-old adult.

Five cases in infants under 15 months have been confirmed, with nine in the 15-month-to-5-year age category - eight in elementary schools - and about 20 in secondary schools, where the outbreak is most severe, Meredith said.

"We have not been successful in containing the epidemic yet," Isaacson told the board. "With the 14-day incubation period, by May 10 we will be dealing with the fourth generation of the epidemic," he said.

"Believe me, it's no fun coming in here in the fourth generation of an epidemic," he told the board. "And we are in an epidemic. It is not well controlled. Unless we can contain these cases, it will not smolder; it will flourish."

According to Meredith, her nursing division immunized 8,146 people last year between January and May. That has increased to nearly 13,000 this year, due in part to the measles outbreak and a new state recommendation that lowered the age of first immunization against diphtheria and polio.

But her department still treated an additional 1,300 patients during the time period, she said.

Special immunization clinics held to combat the measles outbreak are attracting 150 to 200 patients instead of the usual 70 to 80, she said. Instead of the average 300 patients a week, the county is dealing with 1,300.

"We've got them lined up down the hall and out the door into the parking lot, waiting," Meredith said. "It is stretching our staff to the limit. We're doing the best we can. It's not just the clinics, though. We've got 20 phones ringing off the hook all day long, people with questions."

Meredith said the school district has been cooperative in the handling the epidemic, especially in keeping students without immunization rec-ords out of school.

When the outbreak was first diagnosed, more than 300 students at Davis High School were told on a Friday that they would not be allowed back into school, Meredith said.

Her staff spent the weekend contacting parents and helping them locate records. By Monday, some 100 students were immunized in a special clinic set up at the school, then allowed back into class. But about 50 students were held out, Meredith said.

Most doctors in the county have also been cooperative, she said, but a few have been slow in reporting measles patients to the health department. That slows down the isolation process, Meredith said.

The first few days are critical because the disease is highly contagious in that stage, when victims - especially students - suffer only from a runny nose, cough and runny eyes, she said.

They continue to go to school and infect other students. No direct physical contact is required to infect someone, Meredith said. The virus can live in the air of a room such as a classroom or assembly hall for 12 to 24 hours after a victim passes through.


(Additional information)

Confirmed cases

Confirmed measles cases in Davis County:

Infants 5

15 months to 5 years 9

Elementary schools 8

Secondary schools 20

Others 3