Minimize Measles Transmission in Health Care Settings

Quick reference for minimizing the risk of measles transmission in health care settings.

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Follow these steps to minimize the risk of measles transmission:

  1. Query patients with a febrile rash illness* about a history of international travel, contact with foreign visitors, transit through an international airport, or possible exposure to a measles patient in the 3 weeks prior to symptom onset. Suspect measles in patients with such a history.
  2. Mask suspect measles patients immediately. If a surgical mask cannot be tolerated, other practical means of source containment should be implemented (e.g., place a blanket loosely over the heads of infants and young children suspected to have measles when they are in the waiting room or other common areas).
  3. Do not allow suspect measles patients to remain in the waiting area or other common areas; isolate them immediately in an airborne infection isolation room if one is available. If such a room is not available, place patient in a private room with the door closed. For additional infection control information, please see the CDC “Guideline for Isolation Precautions” Attention: Non-MDH link
    For guidance on temporary negative pressure areas see MDH’s “Airborne Infectious Disease Management.”
  4. Allow only health care personnel with documentation of 2 doses of MMR vaccine or laboratory evidence of immunity (measles IgG positive) to enter the patient’s room.
  5. All health care personnel entering the room should use an N95 respirator (regardless of presumptive immunity status) or a respirator with similar effectiveness in preventing airborne transmission. If N95 or other airborne respirators are unavailable, health care staff should at least use a general facemask (surgical, laser, or medical procedure mask). 
  6. Do not allow susceptible visitors in the patient room if possible.
  7. Do not use the examination room for at least 2 hours after the possibly infectious patient leaves. 
  8. Schedule suspect measles patients at the end of the day if possible.
  9. Notify the Minnesota Department of Health immediately of any suspect measles patients; arrange for measles testing at MDH by calling 651-201-5414 or toll free 1-877-676-5414.
  10. Notify any location where the patient is being referred for additional clinical evaluation or laboratory testing about the patient’s suspect measles status and do not refer suspect measles patients to other locations unless appropriate infection control measures can be implemented at those locations. Patient must wear a mask, if feasible, or loosely cover the heads of infants or young children with a blanket during transport to another clinical area.
  11. Instruct suspect measles patients and exposed persons to inform all health care providers of the possibility of measles prior to entering a health care facility so that appropriate infection control precautions can be implemented.
  12. Make note of the staff and other patients who were in the area during the time the suspect measles patient was in the facility and for 2 hours after they left. If measles is confirmed in the suspect case, exposed people will need to be assessed for measles immunity.
  13. Go to Measles Information for Health Professionals for more information on measles and measles testing.

* Measles typically begins with a mild to moderate fever accompanied by cough, coryza, and conjunctivitis. Two to three days later, Koplik's spots (tiny red spots with bluish-white centers inside mouth on the lining of the cheek), which are a characteristic sign of measles, may appear. At this time the fever spikes, often as high as 104-105°F. At the same time, a red blotchy maculopapular rash appears that may become confluent, usually appearing first on the face - along the hairline and behind the ears. This slightly itchy rash rapidly spreads downward to the chest and back and, finally, to the thighs and feet. In approximately one week, the rash fades in the same sequence that it appeared.


Adapted with permission from the California Department of Public Health

 

Updated Tuesday, March 31, 2015 at 02:58PM