Measles for Healthcare Providers

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New Resources from OHA

For all of OHA's most current measles resources, visit here or the specific links below:

  • Measles Prevention, Prophylaxis, and MMR recommendations (Provides FAQs and example scenarios pertaining to recommendations for providers regarding the administration of vaccine and IG prophylaxis during the winter 2019 outbreak activity): https://go.usa.gov/xENWf
  • Measles Testing and Treatment FAQ (Provides FAQs to Oregon providers related to criteria and considerations for measles testing as well as the prevention and treatment of measles): https://go.usa.gov/xENWv
  • Measles Frequently Asked Questions (Provides FAQs for the general public about measles): https://go.usa.gov/xENWd
  • Laboratory Testing for Measles at the Oregon State Public Health Laboratory (OSPHL) (Provides instructions regarding measles specimen collection and submission to OSPHL):https://go.usa.gov/xENWG

As a reminder, measles testing through OSPHL must be approved by local and state public health authorities prior to submission. The process should be:
1) Provider calls local health jurisdiction to request measles testing
2) Local health jurisdiction gathers details about symptoms, vaccination, and exposures
3) Local health jurisdiction consults with epidemiologists about testing approval.
If you have questions, please contact Oregon Public Health at 971-673-1111.

Clinical Presentation of Measles

Be alert to measles symptoms, especially those who are not immune. Deschutes County Public Health is reminding health care providers to consider measles in patients who:

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

Complications include otitis media, pneumonia, diarrhea, and encephalitis. Infants under 12 months of age who have not yet received the MMR vaccine can be particularly vulnerable to measles and its complications. 

If you suspect a measles case, do the following immediately

  • Promptly mask and isolate patients (in a negative-pressure room, if possible) to avoid disease transmission.
  • Immediately report the suspect measles case to the patient's county of residence:
    • Call the communicable disease program immediately by calling the 24-hour phone line at:
      • Crook County: (541) 447-5165
      • Deschutes County: (541) 322-7418
      • Jefferson County: (541) 475-4456
  • If possible, it is useful to obtain pictures of the rash, as they can be used when consulting with an Infectious Diseases Doctor or County Health Officer.
  • Testing should NOT be done with prodrome symptoms only (no rash). OHA may not approve PCR testing without a rash.
  • Persons suspected to have measles should have a serum drawn for serology and specimens collected for RT-PCR at day 1 to day 3 of rash onset, no later than 10 days after rash onset.
  • Criteria for testing at the OSPHL is:

Process for ordering labs

  • St. Charles lab will process and send to Oregon State Public Health Lab (OSPHL) upon approval of Local Health Department. Patients will not be charged for approved testing.

  • Order the following specimens via your normal Electronic Health Record, complete the state virology form (download here) and send to St. Charles Lab:   

    • Measles IgM/IgG Blood Samples: Done by most private labs
      Collect as close to rash onset as possible
      Collect 3-5ml of blood in Red top tube or serum-separator tube (SST) and centrifuge within 2 hours of collection
      Traditional measles IgM has poor sensitivity early in the illness and is only considered reliable if obtained 72 or more hours after rash onset

    • Measles RT-PCR (Nasopharyngeal and Urine): Only done at OSPHL
      Collect on day 1 to day 3 of rash onset, no later than 10 days after rash onset
      Collect Nasopharyngeal sample using a synthetic swab such as Dacron or Rayon and place in viral transport media (VTM)

​*Specimens need to be received within 72hrs of collection and sent on ice to OSPHL. Turnaround time for PCR results is within 3 working days after receipt of specimen.

Laboratory Testing for Measles at the Oregon State Public Health Laboratory (OSPHL) 
OHA Provider Advisory - Measles Testing and Treatment FAQ

Vaccination Information

At this time, Oregon Health Authority is continuing to recommend that providers follow the ACIP MMR vaccine schedule (click here for link) .

Resources 

Patient Handouts:

Websites:

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