Measles - Information for Providers

Measles 3

Maryland Department of Health has issued guidelines for providers regarding measles testing and vaccination.

How do I test for measles?

If you suspect measles in a patient, please call your local health department. In Baltimore City, health care providers are asked to call 410-396-4436 during normal business hours or after business hours call 410-396-3100 to speak to the health department after-hours duty officer. Measles testing involves collection of blood for serological testing and a nasophryngeal (NP) swab for PCR testing at the Maryland Department of Health Laboratories Administration.

What is the protocol if a patient suspects they have been exposed to measles?

Call your local health department to find out if the patient attended one of the locations where a confirmed case of measles was present. Some locations are also listed here.

If the patient is symptomatic, staff who interact with the patient should wear PPE, including gown (if available), gloves, and an N95 mask.

What should we do to prepare for a possible measles case?

Have a plan in place to assess for patients who are possibly symptomatic with measles. If you receive a call from a patient or another provider that a patient with suspected measles is coming to your office, arrange to have them brought directly to an examination room. Have them put on a mask as soon as possible, ideally before entering the office. Placing them in a negative pressure room is ideal, if one is available. It may also be possible to evaluate some patients without bringing them into the office (in their car, etc.). Try to avoid having a patient with suspected measles wait in the waiting room or be around other patients or staff. Measles can stay in the air for up to two hours after infected persons leave.

Evaluate the immune status of your staff. Evidence of measles immunity includes:

  • Written documentation of vaccination with 2 doses of live measles or MMR vaccine administered at least 28 days apart,
  • Laboratory evidence of immunity,
  • Laboratory confirmation of disease, or
  • Birth before 1957.

If staff do not have documented immunity to measles, encourage MMR vaccination.

CDC recommends that healthcare personnel wear PPE when evaluating patients with suspected measles. This includes those who have documented immunity. Ensure your staff are fit-tested for N95s.

If you recommend transfer of your patient to another healthcare provider or ED, please CALL AHEAD to the provider to ensure the receiving provider can minimize exposure to health care workers and other patients.

 

Information for clinicians:

Measles Clinician Letter (April 22, 2019) 

Measles Clinician Letter (April 8, 2019)

MDH Measles FAQ for Clinicians 

CDC Measles Guidance for Healthcare Professionals 

MMR ACIP Vaccine Recommendations

Attachments: Physician Sign, Triage Sign