Health and Human Services Agency
California Department of Public Health

AFL 26-16

May 19, 2026

TO:

General Acute Care Hospitals (GACHs)

SUBJECT:

Measles Preparedness Recommendations for Hospitals

AUTHORITY: Title 22 California Code of Regulations section 70737(a)

All Facilities Letter (AFL) Summary

This AFL provides recommendations and resources for hospitals to use when developing or updating their measles preparedness plans.

Background

Recent increases in measles cases in the United States, including California, highlight the need for healthcare providers to promptly recognize potential measles cases and implement timely isolation and transmission-based precautions to prevent exposure to other patients, visitors, and healthcare personnel (HCP). Measles cases in healthcare settings that are not immediately recognized and appropriately isolated require investigation to identify and manage potentially exposed persons.

Recommendations for Hospitals

To prepare to identify and respond to measles cases, the California Department of Public Health (CDPH) recommends hospitals implement the following:

Maintain awareness of measles risk and cases in their communities.

Refer to the CDPH Measles webpage for updated information on measles cases in California.

Prepare to promptly identify suspect measles cases, implement timely and appropriate isolation and transmission-based precautions, and notify the local health department.

Refer to the CDPH Measles Healthcare Exposure Investigation Quicksheet (PDF) for information on initial triage, evaluation, and infection control measures.
Refer to the Centers for Disease Control and Prevention’s (CDC’s) Evaluating Heating, Ventilation, and Air Conditioning (HVAC) Systems in Healthcare Facilities that Care for Measles Patients Checklist (PDF) for assessing HVAC systems.

Identify key roles and responsibilities and points of contact for measles response, including with the local health department and appropriate CDPH district office.
Develop or update plans to investigate and respond to measles exposures of patients, visitors, and HCP (including non-clinical staff) in coordination with public health.

Refer to the CDPH Measles Healthcare Exposure Investigation Quicksheet (PDF) for information on conducting a contact investigation and assessing measles immunity.
Maintain documentation of measles immune status of all HCP (including non-clinical staff).

Assess supplies of intramuscular (IM) and intravenous (IV) immune globulin (IG) and measles-mumps-rubella (MMR) vaccine as post-exposure prophylaxis (PEP) and identify a source for additional supplies if needed.

Available Resources

For more detailed guidance, hospitals may refer to the following resources:

CDPH Measles webpage - provides up-to-date information about measles activity in California, including the number of measles cases and counties affected, cases by age, and number of hospitalizations and deaths.
CDPH Measles Investigation Quicksheet (PDF) - includes general information about measles, guidance for testing and assessing suspected measles cases, and isolation, quarantine and exclusion considerations for various settings.
CDPH Measles Healthcare Exposure Investigation Quicksheet (PDF) - provides recommendations for triage, evaluation, and infection control for suspected measles cases in healthcare settings. The Quicksheet also includes guidance for contact investigations in healthcare facilities when a measles case is confirmed.
CDC Measles Preparedness and Response in Healthcare Settings webpage - houses documents for hospitals to use including:

Measles Assessment Tool (PDF)
Steps for Responding to Measles Exposure (PDF)
Sample Script to Assess Patients and Visitors (PDF)

Reporting Suspected Measles Cases

All suspected measles cases must be reported immediately to the local health department and CDPH district office.

Questions

For questions regarding the guidance in CDPH's Measles Quicksheets, please contact vpdreport@cdph.ca.gov. For other questions about this AFL, please contact the Healthcare-Associated Infections Program at HAIprogram@cdph.ca.gov.

Sincerely,

Original signed by Mandi Posner

Mandi Posner
Deputy Director

References