Provider alert: Measles in Portland area

08 Jul 2018

Health Alert Network shares guidelines to contain spread

 

Multnomah County Public Health is investigating a confirmed case of measles. The symptom onset was on June 22. About 500 contacts in the Portland metro area are being notified of their exposure. All contacts are being advised to watch for symptoms and seek health care for diagnosis by calling ahead to avoid exposing others in waiting rooms and lobbies.

Please consider measles in patients who:

• Present with febrile rash illness and the “3 Cs”: cough, coryza (runny nose) or conjunctivitis (pink eye)
• Recently traveled internationally or were exposed to someone who recently traveled
• Have not been vaccinated against measles

Health care providers should also consider measles when evaluating patients for other febrile rash illnesses, including dengue and Kawasaki disease.

If you suspect measles, do the following immediately:

1. Mask and isolate patients (in negative-pressure rooms, if possible) to avoid disease transmission.
2. Report the suspect measles case to the health department. The directory of communicable disease programs, including after-hours phone numbers, is located here.
3. Obtain specimens for testing from patients with suspected measles, including viral specimens. Detailed information can be through the Oregon Investigative Guidelines.

International travelers: Encourage timely vaccination for anyone under six months of age who lack evidence of measles immunity. One dose of MMR vaccine is recommended for infants aged 6–11 months traveling internationally, and two doses for persons aged 12 months or older, with a minimum interval of 28 days between doses.

Routine MMR vaccination is recommended for all children, with the first dose given at age 12–15 months and a second dose at age 4–6 years. Unless they have other evidence of immunity, adults born after 1956 should get at least one dose of MMR vaccine, and two appropriately spaced doses of MMR vaccine are recommended for health care personnel, college students and international travelers.

Measles was documented as “eliminated” in the United States in 2000. However, importation of measles cases and limited local transmission continue to occur.

Additional guidance for health care providers can be found at:

CDC measles

CDC Provider Resources for Vaccine Conversations with Patients

Oregon Health Authority Measles webpage                                                                      

Oregon Measles Investigative Guidelines