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Measles - For Health Care Providers

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Published on February 05, 2019. Last modified on June 01, 2019

Current Situation

As of May 29th, 47 cases of measles have been diagnosed among California residents in 2019. Thirty-one 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.

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. Click here for a list of countries with measles outbreaks.

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.
  • Use the California Department of Public Health's Guide: Should I Test for Measles? to determine when testing is appropriate.
  • When indicated, 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.

For More Information

  • Call the Communicable Disease Unit at (831) 755-4521.
  • Visit the Centers for Disease Control and Prevention's measles website.