Suspected Measles Exposure or Infection Clinical Pathway – Emergency Department, Outpatient Specialty Care and Primary Care – Clinical-decision Making for Measles Testing

Suspected Measles Exposure or Infection Clinical Pathway – ED, Outpatient Specialty and Primary Care

Clinical Decision-Making for Measles Testing

  • Symptoms Consistent with Measles
    • Fever plus ≥ 1 of the following:
      • Bilateral conjunctivitis
      • Rash on face, neck, trunk within 24 hrs of fever
  • Rash with Onset in the Past 4 Days on the Face/Torso
    • Rash is not:
      • Limited only to extremities
      • Limited to diaper area
      • Only petechiae
  • Measles rash may appear less typical in:
    • Young infants with partial immunity due to maternal immunity
    • Immunocompromised children
Child Presenting for Possible Testing
 
 
 
 
No Known Exposure
Known Exposure Including Travel to Area of Local Transmission
 
 
 
 
 
 
No Measles Symptoms
Measles Symptoms Present
 
 
 
 
 
 

2 MMRs
or
1 MMR, given at least 2 wks prior to symptom onset

Non-Immune
 
 
 
 

Measles unlikely

No measles testing recommended

If high suspicion,
call 5-SAFE to discuss

Measles unlikely

No measles testing recommended

Measles unlikely

If high suspicion,
call 5-SAFE to discuss

Call 5-SAFE

Measles testing recommended