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Measles FAQs for Medical Staff

Washington state is currently experiencing an outbreak of measles. As of February 18, 2019 they have had 62 confirmed cases. Vancouver Coastal Health confirmed eight cases of measles on February 15, 2019.  No measles cases have been confirmed on Vancouver Island but unimmunized children and adults who travel to Washington State, or have been exposed to infected patients from Vancouver could be at risk for acquiring measles and transporting it to an Island Health facility.

 

FREQUENTLY ASKED QUESTIONS

  1. What is measles?

Measles is a highly contagious respiratory virus.  Commonly known as red measles, it was a common childhood illness before the introduction of widespread vaccination.

 

  1. What are the symptoms?

Symptoms begin with fever, cough and runny nose.  Often there is non-purulent conjunctivitis and the patient is very sensitive to light.  Small blueish-white spots may appear on the buccal mucosa (Koplik spots).  Three days later, a generalize maculopapular rash will appear and last for 4 -7 days.

 

  1. How is it transmitted?

Measles is extremely contagious. It is transmitted via airborne droplets and direct contact with the nasal or throat secretions of an infected patient.

Patients are communicable from about 4 days before the rash onset to 4 days after the appearance of the rash.

 

  1. What is the incubation period?

The usual incubation period is 8-12 days but can be as long as 21 days.

  1. What do I do if I have a patient who I suspect has measles?

Patients arriving at the Emergency Department with symptoms consistent with measles:

  • Triage to a negative pressure room and begin airborne precautions.  If the patient is admitted, ensure that a negative pressure room and airborne precautions will be implemented on the receiving unit.
  • Assess the patient’s likelihood of having measles based on natural infection or completion of a vaccine series.   This also applies to healthcare workers providing care. Consider as likely immune:
    • Children and adults who have had two documented doses of Measles, Mumps, Rubella (MMR) vaccine after their first birthday.
    • Adults who have had prior measles infection.
  • Collect clinical samples for virus detection. Buccal swabs for measles PCR can be collected up to 8 days after onset of rash.  Urine for PCR can be collected up to 14 days after the onset of rash. Swabs must be collected in viral transport media (blue top swab).

measles test table

                                                                                             BCCDC Communicable Disease Control Manual

 

  • Serology should only be collected for Measles IgM and IgG after the rash is evident, and is used to rule out other viral causes such as parvovirus B19 and rubella.  Please note, 20% of measles cases will not have a reactive IgM if tested within the first 3 days of the rash. 
  • Notify the medical microbiologist on call and the MHO on call.

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