Minimize Measles Transmission in Healthcare Settings

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

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To minimize the risk of measles transmission in healthcare settings, healthcare personnel should:

  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. If possible, allow only healthcare personnel with documentation of 2 doses of MMR vaccine or laboratory evidence of immunity (measles IgG positive) to enter the patient’s room.
  5. Healthcare personnel who do not have documentation of 2 doses of live measles vaccine or lab-evidence of immunity must wear a N95 respirator (N95 respirator must be fit-checked each time it is donned). 
  6. If possible, do not allow susceptible visitors in the patient room.
  7. Do not use the examination room for at least two hours after the possibly infectious patient leaves. 
  8. If possible, schedule suspect measles patients at the end of the day.
  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 healthcare providers of the possibility of measles prior to entering a healthcare 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 two hours after they left.  If measles is confirmed in the suspect case, exposed people will need to be assessed for measles immunity.
  13. For more information on measles and measles testing, please see Measles Information for Health Professionals.

* 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 Wednesday, April 20, 2011 at 01:53PM