Potential Measles Exposures in Northern Virginia January 2024

PUBLIC HEALTH INVESTIGATING POTENTIAL MEASLES EXPOSURES IN NORTHERN VIRGINIA

Dear Colleague:

On January 13, 2024, the Virginia Department of Health issued a press release “Virginia Health Officials Investigating Potential Measles Exposures in Northern Virginia” (Attachment 1) that informs persons may have been exposed to a person infected with measles if they were at the following locations at the specified dates and times:

• Dulles International Airport (IAD): the international arrivals area of the main terminal between 4:00 p.m. and 8:00 p.m. on Wednesday, January 3, 2024
• Ronald Reagan Washington National Airport (DCA): Terminal A between 2:30 p.m. and 6:30 p.m. on Thursday, January 4, 2024.

This communication provides the following information that you and your staff should review:

• Virginia Department of Health Press Release on Recent Exposure to Measles at Northern Region Airports (Attachment 1).  
• VDH Measles Fact Sheet (Attachment 2)
• What To Do If You Suspect Measles in A Patient Already in Your Office
• How To Protect Your Patients and Your Office from Possible Measles Exposures Going Forward

***Maintain a high index of suspicion for measles in patients with exposures in the specific airport locations at the dates and times noted above (Attachment 1). ***

MEASLES 101 (See Attachment 2. VDH Measles Factsheet)

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.
Measles is characterized by fever > 101ºF, cough, coryza, and conjunctivitis.
After 3-7 days of illness, a maculopapular rash begins on the face, generalizing to the rest of the body.
NOTE: Patients with measles are contagious 4 days prior to rash onset until 4 days after.

WHAT TO DO IF YOU SUSPECT MEASLES IN A PATIENT ALREADY IN YOUR OFFICE:

• Do not allow such patients to remain in your waiting area.  Immediately provide a surgical mask to the patient. Place the masked person in a private room with negative pressure if available, or a room with a closed door. NOTE: Any shared airspace (including the exam room and waiting area) that has been occupied by the patient should not be used for the next 2 hours.
• Use standard and airborne precautions.
• Only allow staff with documented evidence of measles immunity to work with the patient.
• Call Arlington County Public Health Division (ACPHD) staff immediately to report your suspicion and for guidance on appropriate testing and control measures.  You can reach ACPHD staff 24/7 to report suspect cases of measles and/or to discuss these recommendations and other questions you may have about measles:
  • Monday to Friday, from 8 AM to 5 PM, call 703-228-5200, option #1.
  • Nights and weekends, call 703-558-2222 and ask for the Public Health Duty Officer.

  NOTE: You may be asked to collect up to three specimens to confirm measles: 1) serum, 2) a nasopharyngeal swab, and 3) an oropharyngeal swab.

• For patients needing transport by EMS from your office to the hospital:
  • Notify EMS that you suspect measles, so EMS personnel can take appropriate precautions before arriving at your office 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 when they receive the patient from EMS and protect the other patients from exposure by directing the masked patient to an appropriate exam room.

     

  HOW TO PROTECT YOUR PATIENTS AND YOUR OFFICE FROM POSSIBLE MEASLES EXPOSURES GOING FORWARD:

• Ensure that all eligible patients are adequately vaccinated against measles.
• Ensure all office staff, from direct care to administrative staff, have evidence of immunity to measles: 1) documentation of two doses of measles vaccine or 2) documentation of laboratory evidence of immunity.
• Proactively ask your patients NOT to walk in unannounced when they have fever and rash.  Advise them 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.
• Schedule appointments for patients with suspected measles at the end of the day or when other patients are not present and will not arrive within 2 hours of the scheduled visit for the suspected measles patient.

For more information on the January 2024 Measles Exposures in Northern Virginia, go to VDH. For additional information on measles, visit the CDC Measles website.

Thank you for all you do to control and prevent the spread of communicable diseases in our community.

Sincerely,

Reuben K. Varghese, MD, MPH

Health Director & Director, Public Health Division

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