Combatting Measles: Information and Training Measures for Healthcare Personnel

According to the World Health Organization (WHO) and the Centers for Disease Control (CDC), measles cases are on the rise. As of January 25^th, the CDC reports nine measles cases in the U.S. so far this year. Cases have been reported in Georgia, Missouri, New Jersey, and Pennsylvania. Additionally, several other countries have reported measles outbreaks; the top five countries with the most cases are Yemen, Azerbaijan, India, Ethiopia, and Kazakhstan. There are 67,741 reported cases in these countries alone. With these statistics, it shows that measles can come to the U.S. from anywhere in the world.

Measles is a highly contagious and serious illness. Measles can be dangerous in babies and young children. Between one and three people out of 100 who become ill will die, even with treatment. Symptoms of the illness begin 7-14 days after initial exposure. Symptoms of measles include:

High fever
Cough
Runny nose
Red, watery eyes
Rash (3-5 days after symptoms begin)

Measles is airborne and spreads when an infected person coughs or sneezes. Measles can survive in the air and infect someone for up to two hours after the infected person leaves the area. It is so contagious that if one person has it, 10 people around them can become infected if they are not protected. An infected person can spread measles to others before knowing they have the disease. This can occur up to 4 days before developing the rash and 4 days afterward.

Vaccination is the best way to prevent the spread of measles. The vaccine for measles also protects against the mumps and rubella. It is known as the MMR vaccine. Two doses of the vaccine are 97% effective at preventing measles. While one dose is 93% effective. The first dose should be given at age 12-15 months and second dose between 4-6 years of age.

Healthcare personnel (HCP) should have immunity against measles, mumps, and rubella. HCP born in 1957 or later without serologic evidence of immunity or prior vaccination should be given two doses of MMR vaccine, four weeks apart.

Birth before 1957 is considered acceptable evidence of measles immunity; however, it should be considered to administer two doses of the vaccine unless they have laboratory evidence of disease or immunity to measles and/or mumps.

Patients that are known or suspected to have measles should wear a facemask when they enter a healthcare facility. They should be told before entering a facility any instructions such as which entrance to use and how to notify the staff when they have arrived. Patients with suspected or confirmed measles should be placed in an airborne infection isolation room (AIIR). Once a patient is in the AIIR, their facemask can be removed if they stay in the room. If an AIIR is not available, transfer to a facility with an AIIR should be made as soon as possible.

Once the patient has been dismissed, disinfection procedures using an EPA registered hospital level disinfectant should be used. Manufacturer’s instructions for use should be followed, including the contact time of the disinfectant. Used, disposable personal protective equipment for measles patients should be managed as regulated waste or as directed by state and local guidelines.

Training should be provided to all HCP on standard and transmission-based precautions, and prevention of the spread of measles and other airborne illnesses. HCP should be educated, trained, and demonstrate competency on the proper use of PPE in caring for patients with suspected or confirmed measles. Ensuring training takes place will provide a safer workplace for employees and in turn provide a safe patient environment. If your office needs training in proper procedures related to preventing the spread of airborne illnesses, TMC can help. Don’t hesitate in contacting us and our trained professionals will be happy to assist.

For more information for Standard and airborne precautions:

https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html

For more information on prevention of measles in healthcare facilities:

https://www.cdc.gov/infectioncontrol/guidelines/measles/index.html