UPDATE: The following location has tested negative for measles: Vista Community Clinic, 1000 Vale Terrace Drive, Vista, on Jan. 16 from 11 a.m. to 5:30 p.m. This Vista location has been removed from the possible exposure list.
Two of the North County patients have recovered while a third is currently sick and being kept isolated at home, according to the San Diego County Health and Human Services Agency. In December, they had visited Disneyland, which is where health officials say the outbreak started in Southern California and has since been traced to patients treated in several other states.
The Rancho Bernardo clinic was reopened Monday at 3:30 p.m., and the patient suspected of having measles was discharged.
If the new cases are confirmed by laboratory testing, the total in San Diego County would climb to 13.
The HHSA announced the new probable cases before confirmation so the public could be advised of places where the three went recently, and could have exposed others. The locations, dates and times include:
County health officials don't believe there is a current risk of exposure at those locations.
"It is important for anyone who was at one of these locations during the specified dates and times to watch for symptoms and contact their health care provider by telephone first if they show any signs of the disease," said Dr. Eric McDonald, medical director of the county Epidemiology Program.
"People who have been vaccinated are well protected against measles, but anyone who has not been vaccinated, or who has not had the disease, should take steps now to obtain the shot so that they are protected from future exposures," he said.
None of the three patients in the latest case were immunized against the illness, according to the HHSA.
The Rancho Bernardo Clinic that was closed was the Sharp Rees-Stealy Urgent Care Center at 16950 Via Tazon.
"At 9:30 a.m., a patient came in and suspected that they had measles," said Curtis Ippolito of Sharp Healthcare. The clinic was shut down about an hour later, and was closed for about five hours before reopening, he said. Patients were directed, via a posted notice, to another clinic during the closure period.
Ippolito said around 20 people in the waiting room at the time were interviewed by county health officials and subsequently released.
It was not immediately known if the sick person who came to the clinic was connected to the three latest patients or had been to Disneyland.
Measles develops seven to 21 days after exposure. Early symptoms include high fever, cough, runny nose, and red eyes.
A distinctive red rash usually appears three to five days after early symptoms appear, according to the HHSA. A person is considered contagious four days before the rash appears. The rash begins on the face and head then proceeds downward and outward to the hands and feet. It fades in the same order it began, from head to feet.
Health officials recommend that people born in 1957 or after should have documentation of at least one dose of measles, mumps and rubella vaccine or other evidence of immunity to measles. The Centers for Disease Control and Prevention recommends two doses of the vaccine -- the first at 12 months of age, and the second between ages 4-6.
Complications from measles are more common in children younger than 5 years old and adults 20 years and older, and can include diarrhea, ear infection and pneumonia. Death can occur from severe complications and the risk is higher among younger children and adults.
There is no treatment for measles. Bed rest, fluids and fever control are recommended. People with complications may need treatment for their specific problem.
More information about measles, other vaccine-preventable diseases and the shots that protect against them, is available by calling the HHSA Immunization Branch at (866) 358-2966 or going online to www.sdiz.org.