February 10th, 2015
According to the U.S. Centers for Disease Control and Prevention (CDC), 121 cases of measles have been reported in 17 states from January 1 to February 6, 2015. Most of these cases are part of a large, ongoing, multistate outbreak linked to Disneyland or Disney California Adventure Park. As of February 6, 2015, five confirmed cases of measles have been identified in infants attending a Chicago-area daycare. To date, no cases have been identified in Indiana.
Clinicians should consider measles as a diagnosis in anyone meeting the following criteria:
- Fever of 101°F or greater, AND
- Cough, coryza, or conjunctivitis, AND
- Generalized, maculopapular rash
Isolate suspect measles case-patients and immediately report them to your local health department or the ISDH Vaccine-Preventable Epidemiologist, Mugdha Golwalkar, at firstname.lastname@example.org or at 317-233-7112. For after-hours calls, please contact the ISDH Duty Officer at 317-233-1325.
Other viral illnesses and reactions to antibiotics can cause a rash that may appear similar to measles. A thorough investigation, including a travel history, will provide information to help guide appropriate response by local and state public health officials. Specific information regarding reporting, specimen collection, health care worker protocols, and vaccination can be found on the ISDH Measles website. General information on measles can be found on the CDC Measles and Measles Vaccination websites.
- Ensure all patients are up to date on measles-mumps-rubella (MMR) vaccine and other vaccines. Vaccination of household members and caregivers of infants less than 12 months of age is especially important, since these infants are too young to be routinely vaccinated.
- Vaccinate according to recommended guidelines:
- Children 5 years of age or older should have documentation of two doses of MMR vaccine (separated by at least 28 days). The first dose is recommended at 12-15 months of age, with the second dose recommended between 4-6 years of age, prior to school entry.
- Teenagers and adults without evidence of measles immunity should receive two doses of MMR vaccine separated by at least 28 days.
- A booster dose is not necessary for individuals who have received two documented doses of appropriately administered MMR vaccine.
- For those who travel abroad, CDC recommends all U.S. residents older than 6 months be protected from measles and receive MMR vaccine, if needed, prior to departure. Infants 6 -11 months old should receive one dose of MMR vaccine before departure. Infants who have one dose prior to 12 months of age must still receive a dose of measles vaccine on or after their first birthday and another dose between the ages of 4-6 years per current CDC guidelines to be fully protected and meet school immunization requirements.
- In order to prevent the spread of measles in Indiana, those without adequate immunity to measles will be excluded from attending public activities (school, daycare, work, community events) for at least 21 days if they have been exposed to a case of measles.
Questions call Deb McMahan, MD