An ongoing outbreak of measles in Ohio continues to grow. As of early January 2023, more than 110 cases of measles have been documented in children and more than 30% of identified cases have been hospitalized. More than 90% of cases have occurred in unvaccinated individuals. While cases do not yet appear to have spread outside Ohio, the risk is significant. Measles is highly contagious and exposure events can be extremely impactful in terms of both disease consequences in children and disruption of operations for healthcare facilities. Inpatient and ambulatory healthcare facilities should review their processes for identifying patients who potentially have measles.
Persons with signs or symptoms of measles should be identified promptly, provided a facemask to wear (or if unable to mask, such as an infant, temporarily cover with a lightweight blanket until they can be isolated), and separated from other patients prior to or as soon as possible after entry into a facility. Airborne precautions are needed to prevent exposures. If an airborne isolation room is not available, the patient and family should be moved to a private examination room with the door closed. Additional details can be found at Interim Measles Infection Prevention Recommendations in Healthcare Settings | CDC
Measles typically presents with cough, coryza, conjunctivitis, and a maculopapular rash that starts on the head and expands downward to the trunk and lower extremities. Patients with compatible symptoms/signs of illness AND known exposure, relevant travel, or unvaccinated status should be evaluated carefully. Washington State developed a useful screening tool for this purpose.
For more on the clinical presentation of measles, diagnosis, and treatment: For Healthcare Professionals - Diagnosing and Treating Measles | CDC
Per the CDC (For Healthcare Professionals - Diagnosing and Treating Measles | CDC), people exposed to measles who cannot readily show that they have evidence of immunity against measles should be offered post-exposure prophylaxis (PEP). To potentially provide protection or modify the clinical course of disease among susceptible persons, either administer MMR vaccine within 72 hours of initial measles exposure, or immunoglobulin (IG) within six days of exposure. Do not administer MMR vaccine and IG simultaneously, as this practice invalidates the vaccine.