One, a girl of 7 months, was hospitalized from 21 to 25 August, with viral meningitis in Liberia Hospital. Fever and rash began ten days after her discharge, on 2 September. The other case was a girl 6 months of age, for whom there was no determined source of infection. A detailed investigation took place from 4-8 October, 1997. The epidemiological history of the index case indicates that he likely contracted the virus at El Tamarindo beach, a popular tourist attraction.
Most visitors come from Europe, North America, Canada, South America, and some from Central America.
The largest hotels register between 35,000 and 40,000 tourists per year. All contacts of the index case at the restaurant were interviewed without result. Next, selected hotels were visited. The manager of one said that in early July, three Brazilian tourists were lodged, one of which presented fever upon arrival and subsequently rash appeared. A physician diagnosed measles but did not report the case.