Suspected Measles Exposure Clinical Pathway

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Transport/Referral Process

Primary Care and
Ambulatory Settings

Suspected Measles Exposure

Epic Travel Exposure Screen

Measles Tier 0

Risk Assessment Guidance
for Clinicians
- Measles Exposures in Unimmunized, Underimmunized, or Immunocompromised Children

Location of Tier 0 Risk Assessment
PPE: N95, Patient Masking/Tenting

PHL Campus
- Open ED Room (AIIR if available, other ED room if not available)
- Use T7 Room if no ED Rooms available
KOPH Campus
- ED Room 26, ED Rooms 1-6 for overflow or Triage Room C if no open ED Rooms

Room Closure Requirements

Immunized ≥ 1 MMR
Documented or parent report

Age < 6 mos
Unimmunized
Unknown immunization
Immunocompromised

No isolation required
Symptom-based precautions
Can return to waiting room

Expedite to Room

AIIR as available or regular room w/door closed
Airborne precautions
- N95 or PAPR + Eye Protection

AIIR Rooms

PHL ED: 14, 15, 27, 28, 45, 46, 47
KOPH ED: 26
Document and place door sign for
Airborne + Respirator Precautions
Room cleaning
AIIR Room to stay closed for 20 min w/door closed before cleaning
In not AIIR, rooms closes for 2 hrs before cleaning
Room Closure Requirements

Asymptomatic

Symptomatic

Measles testing
not required

Measles Testing
- NP for Measles PCR
- Serum Measles IgM, IgG
- Urine Measles PCR
Call 5-SAFE before
ordering studies

Post-Exposure Prophylaxis, Not Pregnant or Immunocompromised, Quarantine Recommendations
Post-Exposure Prophylaxis, Pregnant or Immunocompromised Quarantine Recommendations
Consult with Medical Home, ID for Immunocompromised Children
HCG required before MMR: Menarche and/or age > 12 yrs

Discharge

Admit

CDC MMRV Vaccine Information Sheet
Quarantine at home, 21-28 days
Monitor symptoms
- Call PCP if symptoms develop

As clinically indicated
AIIR or single room w/door closed
Airborne precautions

Posted: August 2023
Editors: Clinical Pathways Team

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

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Clinical Pathway for Management of Suspected Measles Exposure