Current Situation – August 2016
Sporadic cases of measles continue to be identified in California and the United States.
Recommendations for Medical Providers
1. Encourage your patients to get vaccinated, especially prior to international travel.
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 children ages 6 to 11 months.
Some adults should also get MMR vaccine. Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine unless they are certain they had the diseases. Two doses are recommended for healthcare workers, students, educators, and international travelers.
2. Keep an eye out for measles symptoms.
Suspect measles in patients with:
- Fever and rash, and
- History of international travel (particularly to Europe or Asia) and/or contact with international visitors in the prior 3 weeks.
The course of measles is usually:
- Onset of a mild to moderate fever accompanied by cough, coryza, and conjunctivitis.
- Two to three days later Koplik’s spots (tiny blue/white spots on the bright red background of the buccal mucosa) may appear.
- The fever spikes, often as high as 104-105°F, at this time.
- Concurrent with the fever spikes, a red blotchy maculopapular rash appears, usually 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.
3. Act immediately if you suspect measles.
- Implement airborne infection control precautions immediately. Mask and isolate the patient. Use a negative pressure room if available.
- 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.
- Only allow medical personnel who are immune to measles to be near the patient.
- Do not use any regular exam room for at least 2 hours after a suspected measles patient has left the room.
- Expedite measles testing (both IgM and IgG serology and PCR) through the Monterey County Public Health Laboratory at (831)755-4516. Use of commercial labs may delay diagnosis. The Health Department will request nasopharyngeal, urine, and blood specimens for testing.
- Do not refer suspect measles patients to other locations for clinical evaluation or laboratory testing unless appropriate infection control measures can be implemented at those locations.
Printable Resources for Your Office and Patients
Visiting Another Country Flyer English:
Visiting Another Country Flyer Tagalog:
Attention: You Could Have Measles poster:
Measles Alert flyer for providers:
For More Information
Contact the Communicable Disease Unit at 831-755-4521.
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