Measles For Healthcare Providers

Overview

As healthcare providers, you are the frontline resource to parents and patients who are concerned about measles exposure or illness. This information is to assist you with patients and managing suspected cases.

About Measles

• Measles is a highly infectious viral disease spread through breathing, coughing, sneezing, and contact with aerosolized droplets or secretions from the nose, mouth, and throat of an infected person.
• It is characterized by fever >101ºF, cough, coryza (runny nose), and conjunctivitis.
• After three to seven days of illness, a maculopapular rash begins on the face, generalizing to the rest of the body.
• NOTE: Patients with measles are contagious four days prior to rash onset until four days after rash onset.

If You Suspect Measles

Call Arlington County Public Health Division immediately to report your suspicion and for further guidance on appropriate testing and control measures:

• Monday to Friday, from 8:00 a.m. to 4:30 p.m., call 703-228-7444.
• On nights and weekends, call 703-558-2222 and ask for the Public Health Duty Officer.

• Do not allow a patient with suspected measles to remain in your waiting area.
• Immediately provide the patient with a surgical mask.
• Require staff working with the patient to wear a N95 respirator mask (preferred if available) or surgical mask.
• Bring the patient to a private room with negative pressure if available, or to a room with a closed door. NOTE: Do not use the room for two hours after the patient leaves.
• Use standard and airborne precautions.
• Only allow staff with documented evidence of measles immunity to work with the patient.
• Be prepared to collect specimens based on ACPHD recommendations:
  • Serum
  • Nasopharyngeal swab
  • Oropharyngeal swab
  • Urine
• For patients that need EMS transport from your office to the hospital:
  • Notify EMS that you suspect measles, so EMS personnel can take appropriate precautions, including N95 respirator masks, to protect themselves from exposure during transport.
  • Notify the receiving hospital that you suspect measles, so hospital personnel can take appropriate precautions to protect themselves and their patients from exposure when receiving the patient with suspected measles from EMS.

Protect your Patients and Staff from Possible Measles Exposures

• Ensure all eligible patients are adequately vaccinated against measles.
• Ensure all staff, from direct care to administrative staff, have documented evidence of immunity to measles:
  • Two doses of measles vaccine
  • Laboratory evidence of immunity (titers)
• Proactively ask your patients NOT to come in unannounced if they have a fever and rash.
• Advise patients to report fever and rash symptoms when they call to request an appointment.
• Instruct staff to ask patients about fever and rash symptoms when they request an appointment.
• For patients with suspected measles, schedule appointments for the end of the day or when other patients are not present.
• Ensure no other patients are in the office while the patient with suspected measles is present and for two hours after the patient leaves.