With more than 600 doses of the vaccine that prevents measles, the Martha’s Vineyard Hospital began inoculating unvaccinated children and adults Wednesday evening, following a confirmed case of measles on the Island.

The hospital and the Massachusetts Department of Health issued an alert on Monday, advising residents and visitors that an unvaccinated child visiting from another state was diagnosed with the highly contagious disease, after visiting the hospital emergency room on June 17. Lab tests confirmed the diagnosis on June 19, which triggered a series of protocols involving DPH, the hospital, and local boards of health, to prevent spread of measles which is transmitted through the air. No new cases of measles have been diagnosed.

“While the child was immediately identified and subsequently isolated from the community, we know that individuals on the Island were exposed to the virus during a phase of the illness in which the patient is infectious but has no symptoms,” the hospital said in the alert posted on its website Monday morning. The hospital has set up a measles hotline at 508-957-0117.

The DPH said it was the second confirmed case of measles in the state this year.

On Wednesday, about a dozen adults and children arrived at 5 p.m. as the clinic opened. Volunteers from boards of health and emergency management personnel directed traffic and guided people into the doctor’s wing of the old hospital, where they filled out paper work, took a number and waited in a short line. Inside the clinic, nurses prepared the vaccine, which must be mixed shortly before the inoculation, as patients streamed in. Children were taken to exam rooms, where an occasional burst of shrill wailing punctuated the orderly atmosphere. Adults were given an injection at hallway tables. By the end of the clinic at 9 p.m., the hospital staff had immunized 89 adults and children.

Hospital sent out alerts after measles case was confirmed. Libraries canceled story hours around the Island. — Mark Alan Lovewell

A second clinic was scheduled for Thursday evening.

Hospital president Timothy Walsh stood by, looking on the bright side of the serious medical issue. He said the measles case might serve as a wake-up call, and the free clinics might make the Island less vulnerable to a future outbreak of contagious childhood diseases. “It helps chip away at the number of unimmunized kids on the Island,” Mr. Walsh said.

Dr. Jeffrey Zack, chief of emergency medicine at the hospital, said the patient was considered infectious from Monday, June 8 through Wednesday, June 17.

When the child arrived at the emergency room June 17, it presented an immediate and urgent challenge for the hospital. Hospital staffers and others in the emergency room were exposed.

“We had to identify all the hospital employees and patients where the patient [with measles] was,” Mr. Walsh said. The hospital worked through the weekend to verify whether those people were vaccinated. Those who could not produce proof of vaccinations were identified and isolated. Mr. Walsh said the hospital staff and DPH worked deliberately, according to established protocols, to prepare for the alert issued Monday morning. “Father’s Day, everybody was in here working it through,” he said. “Before the word gets out, we have to know what to do. I think we were real fast. DPH took on where the patient went on the Island. That’s a tough one.”

According to the hospital alert, known locations where exposures to others are likely to have occurred include:

The West Tisbury public library on June 8, from 11 a.m. to 3 p.m.; the Aquinnah library on Tuesday, June 9 from 3 to 5:30 p.m. and again on Thursday, June 11 from 3:30 to 6:30 p.m.; the Martha’s Vineyard Airport Laundromat in West Tisbury on Friday, June 12 from 1 to 5 p.m.; Sharky’s Cantina in Oak Bluffs on Tuesday June 16, from 7:30 to 10:30 p.m., and Ryan Family Amusements in Oak Bluffs on June 16, from 5:30 to 9:30 p.m.

The Chilmark board of health issued an erroneous alert on Tuesday, saying the child visited the Chilmark Library and playground on June 17, the same day of the diagnosis. An updated alert said the child did visit those locations, but it was on June 8, from 2:30 to 5 p.m.

People under the age of 58 who have not been vaccinated, have not had measles in the past, or do not have blood work indicating immunity to the disease should attend the clinic, the Martha’s Vineyard Boards of Health urged. People born before 1957 likely have immunity to the disease, the DPH said.

Hospital officials stressed that the first thing to do if a child has symptoms is to call the doctor, but do not go to the doctor’s office or an emergency room. Doctors will screen patients over the phone, and provide instructions, if a child needs to be seen by a physician.

“The emergency room will be alerted, and you will be brought in through a decontamination entrance, and the staff will be properly dressed in precaution suits,” said hospital spokesman Rachel Vanderhoop.

High fever, a rash that begins on the head, or a runny nose and cough are all possible symptoms that should result in a call to a doctor. The hospital also recommends calling a doctor if you or your child are not vaccinated, or unsure of immunization status.

“There is certainly a lot of concern, folks wanting information,” Dr. Zack told the Gazette in a telephone interview Monday. “We would like to make sure the public understands if they have questions they should contact their primary care doctor. The one thing we don’t want is people coming into the hospital or into the doctor’s office if they think they have measles. Letting someone into the building can make it an infectious area, at least for a couple of hours. It’s most important not to spread this within the hospital,” he said.

Organizations that host children’s activities were cautious, but only a few changed schedules or canceled events. Island schools sent an informational notice to all parents.

Vineyard library directors announced late Tuesday that the annual summer reading kickoff for children at the Agricultural Hall Saturday morning was canceled out of precaution.

In West Tisbury, the Lego club on Saturday morning was canceled, and Monday story hour is canceled for the foreseeable future, said library director Beth Kramer. She said on Monday, staffers began handing out information about measles and the possible exposure.

“Some people decide to stay, some sit outside, other people leave, but everyone has been grateful for that information,” Ms. Kramer said.

DPH asked all library employees to demonstrate immunity, or get vaccinated. Ms. Kramer gave employees the option not to work until July 9, a date beyond the incubation period for measles following the last known exposure.

In Oak Bluffs, the Book Babies event went on as scheduled at the library Thursday morning. “We haven’t been canceling any programs, but we do speak to everyone that enters the building with underage babies,” said library director Sondra Murphy. “This morning I waited outside with the information and approached all the mothers that came and talked to them about it. Nobody here seems to be that worried but I think most, if not everyone have been vaccinated.”

J.B. Blau, who owns Sharky’s Cantina in Oak bluffs, said his first concern was for his staff and customers, but he was also concerned about a loss of business. He took a proactive approach.

“You have to be, this is life or death for a restaurant,” Mr. Blau said. “There is obviously a perception about things like this so we wanted to make sure we were communicating very clearly.”

As soon as the alert was issued, Mr. Blau began to verify the vaccination status of his staff. Those who could not produce paperwork proving vaccinations were tested until the entire staff was cleared, as required by DPH.

Using an extensive social media network, Mr. Blau sent out updates and he said there was no loss of business
“People seem to be taking it in stride,” he said. “We need to stress the restaurant is safe. This is one of the most important things we’ve faced. We were tested like we haven’t been in 10 years.”

Measles can cause serious problems like ear infections, pneumonia, swelling of the brain in some people, especially pregnant women, infants, and those with weakened immune systems, according to the hospital. In rare cases, measles can lead to death. Martha’s Vineyard may be especially vulnerable to the spread of the contagious illness, because it has some of the lowest vaccination rates in the state, according to DPH records.

In West Tisbury, 26.4 per cent of the students are under-vaccinated or not vaccinated, because their parents have filed an objection to vaccinations on religious or medical grounds. For the current school year, only two other schools in the state have a higher rate of exceptions to the state law requiring vaccinations in most cases.

The Tisbury School had a rate of 13.9 per cent, or about 44 students. Edgartown had the lowest exemption rate on the Island, at 2.6 per cent. The state average was 1.5 per cent.

Dr. Zack said the confirmed case of measles demonstrates the vulnerability of an isolated community that sees a huge influx of summer visitors. “We live in a very small world,” he said. “We’re at risk, no matter where we live. We’re about to hit high season and we’re getting people from all over the place.

“This is sort of an opportunity to reeducate everyone to the risks and benefits of vaccination. The problem is when you don’t see a disease like measles for 50 years, people forget about the repercussions and why we started vaccinating in the first place. It killed thousands and thousands of people before vaccinations. We don’t want to see those days, obviously, again.”

Megan Cerullo contributed reporting.