Measles Provider Guidance

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Measles typically starts with symptoms similar to a common cold including a fever, cough, runny nose, pink eye, followed three to five days later with a blotchy rash which spreads from the face to the rest of the body. Additionally, koplik spots, which are small blue/white spots on the inside of the cheeks, may be present. Measles is considered one of the top five most common childhood infection rashes, including chicken pox, rubella, roseola, and fifth disease. 

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It is vital to take steps and follow best practices to protect your other patients in your clinic from unnecessary exposure in waiting rooms or treatment rooms. Measles is a highly contagious airborne virus. If possible, having suspected measles patients enter the clinic using a separate entrance into individual isolation treatment rooms is best practice. Additionally, it is recommended that staff who provide care to these patients have two doses of the MMR vaccine and wear appropriate personal protective equipment at all times, which includes an N95 type mask. Once the suspected measles patient leaves the clinic, ensure the treatment room is left undisturbed for two hours and then properly decontaminated before using it for other patients. 

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Measles testing typically involves collecting a respiratory sample, either a nasopharyngeal swab or throat swab, urine specimen, and, if needed, a blood sample to confirm the presence of the measles virus. Measles is a highly contagious airborne virus. It is recommended that staff who provide care to these patients have two doses of the MMR vaccine and wear appropriate personal protective equipment at all times, which includes an N95 type mask. Please contact your local health department before initiating the measles testing to discuss what types of samples would be most appropriate. The local health department will coordinate with DHHS to use the Nebraska Public Health Laboratory to ensure streamlined testing for the quickest results. 

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Immediate actions are to isolate the patient, report the case to your local health department, and follow standard and airborne precautions, including hand hygiene, appropriate PPE, and respiratory hygiene practices. All staff who provide care to this patient should have two doses of the MMR vaccine. If possible, avoid transferring the patient to other locations in your clinic for testing or evaluation to reduce unnecessary exposure to other patients. Any necessary testing should be performed in the isolation area. Once the suspected measles patient leaves the clinic, ensure any room the patient has been in is left undisturbed for at least two hours and properly decontaminated before using it for other patients. Additionally, create a list of patients in the office at the time the suspected case was there AND a list of healthcare personnel who encountered the patient. This will help the local health department with case investigation. 

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