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Health Update - Measles Cases in California

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Published on April 08, 2019. Last modified on October 04, 2019

 April 4, 2019

 

From:  Edward L. Moreno, MD, MPH                                                             Kristy Michie, MS

             Health Officer    831-755-4585                                                           Epidemiologist     831-755-4503

Health Update

Measles Cases in California

Current Situation

As of March 27th, 16 cases of measles have been diagnosed among California residents in 2019.  Eleven of these cases were outbreak-related and linked to travelers exposed in countries like Israel, Ukraine, and the Philippines where large measles outbreaks are occurring. There have been no confirmed cases of measles in Monterey County in 2019 to date. 

 

Recommendations for Medical Providers

  1. Encourage your patients to get vaccinated.
    • Children should get 2 doses of MMR vaccine: the first at 12-15 months of age and the second at 4-6 years of age.One dose is recommended prior to international travel for unvaccinated infants ages 6 to 11 months.
    • Adults born during or after 1957 who do not have evidence of immunity should get at least one dose of MMR vaccine.Two doses are recommended for healthcare workers, post-high school students and international travelers. See the CDC website for detailed recommendations and contraindications at https://www.cdc.gov/vaccines/vpd/mmr/hcp/recommendations.html.
  2. Keep an eye out for measles symptoms.
    • Measles starts with a mild fever accompanied by cough, coryza, and conjunctivitis.
    • Two to three days later the fever spikes, often to 104-105°F, and a red blotchy maculopapular rash appears, usually first on the face, along the hairline. This slightly itchy rash rapidly spreads downward.
    • Patients with rash and fever and recent travel to countries with current measles outbreaks are at higher risk of measles. A list of countries with measles outbreaks is available at https://wwwnc.cdc.gov/travel/notices/.
  3. Act immediately if you suspect measles.
  • Implement airborne infection control precautions immediately.Mask and isolate the patient.
  • Call the Monterey County Health Department immediately at (831) 755-4521. After normal business hours, call (831) 755-5100 and ask for the Hazardous Materials Team, who will connect you with the on-call Health Officer.
  • Only allow medical personnel who are immune to measles to be near the patient.
  • Expedite measles testing through the Monterey County Public Health Laboratory (831)-755-4516.Use of commercial labs may delay diagnosis and expose others needlessly.
    • Collect 10-15 mL of urine in a sterile collection container AND a throat specimen using a synthetic swab (e.g., Dacron) placed in liquid viral or universal transport medium.
  • Do not use any regular exam room for 2 hours after a suspected measles patient has left the room.

 

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