Wednesday, January 16, 2019

Measles Health Advisory

2/17/2015 Free CME On Demand Webinar Measles Update: A Primer for Health Care Providers

Situation Update

Measles activity continues to increase in California. As of January 30, 2015, 79 cases of measles in patients from 11 different jurisdictions have been reported to the California Department of Public Health. Fifty-two California cases and 14 out-of-state cases are epidemiologically linked to Disneyland Park in Orange County. Five confirmed and two probable cases are Riverside County residents. Students without documentation of two MMR vaccinations have been excluded from two high schools pending the end of the 21 day surveillance period.

Measles Alert

Prompt identification and implementation of infection control measures can make a difference in preventing the spread of measles in our community. Health care facilities should routinely ensure that healthcare workers are immune to measles, as well as other vaccine preventable diseases. Non-immune health care workers may need to be excluded from work and quarantined from day seven through day 21 post exposure.

If You Suspect Measles:
  • Isolate the patient immediately using airborne and standard precautions. The risk of measles transmission to others can be reduced if control measures are implemented.
  • Place patient in a surgical mask, if it can be tolerated.
  •  Do not use the examination room for at least two hours after the measles case (or suspect) leaves.
  • Restrict care of patients with suspect or confirmed measles to immune healthcare workers.
  • Collect specimens for measles testing:
       o Draw 2-5 cc blood in a red-top tube; spin down and remove serum if possible.
          NOTE: Capillary blood (approximately 3 capillary tubes to yield 100 µl of serum)
                       may be collected in situations where venipuncture may be difficult,
    such as for children less than one year of age.
       o Obtain a throat or nasopharyngeal swab using a Dacron swab to dislodge
           epithelial cells; use a viral culturette and place it into a 2-3 ml viral transport media.
       o Collect up to 50-100 ml of urine from the first part of the urine stream
           in a sterile 50 ml centrifuge tube or urine specimen container.
  • For questions on submission of specimens to the County of Riverside Public Health Laboratory, please call Megan Crumpler, Assistant Laboratory Director at (951) 358-5070.
Management of Exposed Individuals

  • IG may be given to exposed susceptible individuals of any age, if given within six days of exposure.
  • MMR vaccine may be given within 72 hours of exposure to individuals six months of age and older with one or no documented doses of MMR, if not contraindicated (two MMRs given after one year of age are still indicated).

Reporting

Notify Disease Control immediately of any suspect measles patients by calling (951) 358-5107 during regular business hours or (951) 782-2974 after-hours (request to speak with the Public Health second call Duty Officer).

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