Backgrāāāāound
The Centers for Disease Control and Prevention (CDC) is reporting an increaseāÆof measles in international travelers, resulting in at least 45 cases reported nationwide so far in 2024. Four cases have been reported in California, all of whom traveled overseas. Delays in identifying and isolating measles cases in health care settings can result in exposures to hundreds of additional contacts.
āRecommendationsā
Suspect measles in patients with:
Fever, rash, and any of the ā3 Csā ā cough, coryza, or conjunctivitis
In the prior 3 weeks, any of: travel outside of North America, transit through U.S. international airports, or interaction with international visitors (including at U.S. tourist attractions).
Prevent spread if measles is suspected:āÆ
Mask the patient immediately. If an infant or young child cannot wear a surgical mask, use another practical means of source containment during escort to an isolation room, such as placing a blanket loosely over the head (to not restrict breathing).
Bypass the waiting room if possible: keep patients out of the waiting area or other common areas.
Isolate the patient immediately, in an airborne infection isolation room (AIIR) if possible. See CDC and CDPH (PDF) infection control guidance. āÆInfected people are contagious from 4 days before rash onset through 4 days after rash onset.
All healthcare personnel entering the patient room, regardless of immune status, should use respiratory protection at least as effective as an N95 respirator per Cal/OSHA requirements.
Promptly telephone the local health deāāpartment (LHD) to report suspected measles cases, even before laboratory confirmation.āÆ
If advised to test for measles by your LHD, submit a specimen for measles polymerase chain reaction (PCR) testing. (Measles IgM testing is frequently falsely positive and is not recommended).āÆ
Ensure that patients are up to date on measles vaccinations. Before traveling abroad:
Infants 6 to 11 months old need 1 dose of MMR vaccine.
Children 12 months and older need 2 doses of MMR vaccine.
Adults born during or after 1957 without evidence of immunity against measles need documentation of two doses of MMR vaccine at least 28 days apart.āÆāÆ