MEASLES (RUBEOLA)

Overview:

Measles is an acute viral respiratory illness. It is one of the most contagious of all infectious diseases; approximately 9 out of 10 susceptible persons with close contact to a measles patient will develop measles. The virus lives in the nose and throat mucus of an infected person. Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected.

 

Mode of Transmission:

Airborne

 

Examples of Transmission:

The virus is transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes. In addition, the measles virus can live for up to two hours in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected. 

 

Prevention:

MMR Vaccine

 

Precautions:

Universal, and Airborne

 

Signs and Symptoms: The symptoms of measles generally appear about seven to 14 days after a person is infected.

Measles typically begins with

  • high fever,

  • cough,

  • runny nose (coryza), and

  • red, watery eyes (conjunctivitis).

 

Two or three days after symptoms begin, tiny white spots (Koplik spots) may appear inside the mouth. Three to five days after symptoms begin, a rash breaks out. It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet. Small raised bumps may also appear on top of the flat red spots. The spots may become joined together as they spread from the head to the rest of the body. When the rash appears, a person’s fever may spike to more than 104° Fahrenheit. After a few days, the fever subsides and the rash fades.

 

Complications:

Ear infection, diarrhea, pneumonia, and/or inflammation of the brain (encephalitis). One or two of every 1000 children who get measles will die from it.

 

Exposure Determination:

A significant airborne exposure is a combination of a subject (source) showing signs/symptoms of suspected airborne illness plus an activity that would place you at risk of droplet or airborne exposure, and does not usually require immediate medical attention. 

  • Source of Exposure: Aerosolized exhalation, sputum, or saliva, either by source coughing, spitting, or breathing. Or any pulmonary (lung) secretions either brought forth by patient (source) themselves or by suctioning while you were not wearing appropriate barrier protection. 

  • High Risk Activities: The following activate the gag/cough reflex. Manual suctioning of naso-pharyngeal airway, Insertion of nasogastric tube, or endotracheal intubation.

 

General Post Exposure Treatment:

If given within 72 hours of exposure to measles, measles vaccine may provide some protection. In most settings, postexposure vaccination is preferable to use of immune globulin. Immune globulin can be administered within 6 days of exposure and is indicated for susceptible household or other close contacts of patients with measles, particularly contacts younger than 1 year of age, pregnant women and immunocompromised persons, for whom risk of complications is highest.

 

The CDC has specific guidance for outbreaks in medical settings: all personnel born during or after 1957 should receive two doses of MMR vaccine, unless they have documentation of measles immunity. Personnel born before 1957 without documentation of measles immunity should receive one dose of MMR. Serologic screening of healthcare workers during an outbreak to determine measles immunity is not generally recommended, because stopping measles transmission requires the rapid vaccination of susceptible healthcare workers.

 

Susceptible personnel who have been exposed to measles should be relieved from patient contact and excluded from the facility from the 5th to the 21st day after exposure, regardless of whether they received vaccine or immune globulin after the exposure. Personnel who become ill should be relieved from all patient contact and excluded from the facility for 4 days after they develop rash.

 

Paperwork Required:

  1. OC Public Health Communicable Disease Exposure Form (policy 330.96) with Fire incident number on top. Should be faxed while still in the hospital Fax: (714) 564-4050 But per policy report IMMEDIATELY by telephone.

 

OC Public Health Communicable Disease Exposure Form

  1. The City “Report of Employee Injury” form

  2. Medical Service Order- RM -67 (when medical care is required)

Call

M: 949-769-1162

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