Measles case in a King County resident with unknown exposure

Actions requested

• Be aware of a confirmed measles case in a King County child with unknown exposure (no international travel) and unknown vaccination history. See public exposure locations below. 
• The infectious period for this case is May 11–May 19, 2023
• Secondary cases resulting from this case would be expected to occur during May 18 through June 9, 2023. 
• Assess immunization status of patients at every visit and strongly recommend vaccination based on recommended schedule, health condition, occupation, and other risk factors such as travel; Under-vaccinated individuals may be at risk for measles infection due to outbreaks that occur in the US or anywhere else in the world.   
• Consider measles infection in exposed patients with compatible symptoms, including: 
• Prodrome of fever, cough, coryza and conjunctivitis for 2-4 days 
• Generalized maculopapular rash that usually begins on the face at the hairline and then spreads to the neck, trunk, and extremities
• Koplik spots may appear on buccal mucosa 1-2 days prior to rash
• Be prepared for the possibility of patients with measles at your facility: 
• Suspected patients should wear a mask covering the nose and mouth
• In urgent/emergency healthcare settings:
• Suspected patients should be triaged immediately away from waiting rooms 
• Room patient in airborne isolation if available 
• In outpatient clinic settings:
• Schedule suspected patients to be seen at end of day, if possible, and keep them out of waiting rooms
• Use standard and airborne infection control precautions
• Only staff with documented immunity to measles should enter patient’s room. 
• After patient is discharged, do not use or have staff enter the room for 2 hours. 
• Collect specimens on patients with suspected measles for diagnostic testing:
• For PCR and virus isolation:
• Nasopharyngeal swab placed in viral transport media (VTM)
• Urine, minimum 20mL, in sterile leak proof container
• For measles IgM serology:
• Serum, minimum 1mL, in red top or red-grey top tube
• Route specimens through Public Health to expedite testing (do not use commercial laboratory).
• Report suspected cases of measles to Public Health at (206) 296-4774 immediately before discharging or transferring patients.