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Health Advisory: Multistate Measles Outbreak, 2015
Action requested:
Ensure all patients are up to date on measles, mumps, rubella (MMR) vaccine.
All U.S. residents older than 6 months traveling abroad should have evidence of measles immunity:
o Infants 6 – 11 months old should receive 1 dose of MMR vaccine
o Children 12 months and older and adults born after 1956 should have documentation of 2 doses of
MMR (separated by at least 28 days)
Consider measles in patients with compatible symptoms, including:
o Prodrome of fever, cough, coryza and conjunctivitis for 2-4 days
o Generalized maculopapular rash that usually begins on the face
o Koplik spots may appear on buccal mucosa 1-2 days prior to rash
Ask patients about recent travel internationally or to domestic venues frequented by international travelers,
as well as a history of measles exposures in their communities.
Collect specimens on patients with suspected measles
o Serum for measles IgM
o Specimens for viral culture: nasopharyngeal swab or wash, urine
o If measles is highly suspected contact JCPH at 360-385-9400 to route laboratory specimens through
the State Public Health Lab to expedite testing, do not use commercial laboratory
Instruct reception staff to identify patients presenting with symptoms of possible measles.
o Promptly isolate patients with suspected measles. Patients should wear a mask covering the nose and
mouth and should be kept away from other patients.
o Room patient immediately and close the door.
o Only staff with documented immunity to measles should be allowed to enter the patient’s room.
o After the patient is discharged, do not use room for 2 hours.
Report suspected cases of measles to JCPH at 360-385-9400 immediately before discharging or transferring
patient.
Background:
The US is experiencing a large multi-state measles outbreak that started in California in December 2014 and has spread
to six additional states and Mexico. From December 28, 2014 through January 21, 2015, more than 50 people from six
states were reported to have measles (linked to an initial exposure in December at Disneyland or Disney California
Adventure Park in Anaheim, California); there have been two cases in Washington to-date. Healthcare professionals
should consider measles when evaluating patients with febrile rash and ask about a patient's recent international travel
history and travel to domestic venues frequented by international travelers.
Resources
CDC Measles Information http://www.cdc.gov/measles/hcp/
http://emergency.cdc.gov/han/han00376.asp