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Measles Information For Providers

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How should providers report?

  1. Call Contra Costa Public Health immediately (24/7) to report it (see table below for phone numbers)
  2. Complete the Contra Costa Public Health Measles Case History Form.
  3. Fax a copy of the completed form to Public Health at 925-313-6465.

 

 TIME  PHONE  NOTES
 Business hours (8 a.m. – 4:30 p.m., M-F excluding holidays)  925-313-6740  Communicable Disease Programs staff will answer.
 After hours (including holidays)  925-646-2441  Sheriff's dispatch will answer and ask for the health officer on-call.

What can providers do?

Although initially thought to be eliminated in the United States in 2000, 2019 marked a measles (rubeola) resurgence in the United States.  Measles cases are expected to continue to rise due to recent decreased uptake in routine vaccinations and an increase in global incidence.

Be aware of key risk factors for measles: 

  • Being unvaccinated or not fully vaccinated 

  • International travel and/or travel to an area with a known outbreak

Consider measles in patients presenting with febrile rash illness and clinically compatible measles symptoms (cough, coryza, and conjunctivitis)

Ask patients about recent travel internationally or to domestic venues frequented by travelers, as well as history of measles in the community. 

Ensure that patients are up to date with all vaccinations, especially if travel abroad is planned. 

Testing

Should I test for measles?

Follow the steps in the Should I Test for Measles? guide.

Measles is characterized by a fever followed by a descending, maculopapular rash. Here are the symptoms to look for:

  • Measles usually begins with a high fever and one or more of the “3 Cs”: cough, coryza, conjunctivitis.
  • The rash develops after the fever and typically appears first on the face, along the hairline, and behind the ears and then spreads downward to the rest of the body.
  • The rash is erythematous and maculopapular, progressing to confluence in the same order as the spread of the rash.
  • Confluence is most prominent on the face.
  • The rash begins to clear on the third or fourth day in the same order it appeared.
  • Fever typically peaks 2 to 3 days after rash onset.

How do I test for measles?

Lab testing is coordinated through Contra Costa Public Health Laboratory. The lab will run a reverse-transcription polymerase chain reaction (RT-PCR) test.

First, report the suspected case to get approval for testing. Then, to test for measles:

  1. Collect specimens.
    1. Urine (10-50 mL in a sterile container), AND
    2. Dacron swab of the throat (preferred) or nasopharynx in viral transport media (VTM).
  2. Send specimens to Contra Costa Public Health Laboratory.
    1. For each specimen in the shipment, complete and include the laboratory request slip.

View the testing guide for more details.

Infection Control

If you suspect that your patient has measles, take the following steps:

  • Immediately mask and isolate the patient.
  • Place them in a negative pressure room when available.
  • If one isn't available, examine them outside the facility or in a private room with the door closed.
  • Minimize the time the patient spends in the facility.

Other precautions apply. Learn more:

Resources

Physicians who need to report a suspected communicable disease emergency should contact the Contra Costa Health Communicable Disease Programs immediately at 925-313-6740. After hours, call Sheriff's dispatch at 925-646-2441 and ask for the health officer on call.