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

Emergency Department, Outpatient Specialty Care and Primary Care Clinical Pathway
for Management of Suspected Measles Exposure or Infection

Locations/Dates of
Possible Measles Exposure
Child with Suspected Measles Exposure
 
 

Epic Travel, Exposure and Symptoms Screen

Point of Entry PPE Kit
 
 
Measles Symptoms
  • Fever plus ≥ 1 of the following:
    • Bilateral conjunctivitis
    • Rash on face, neck, trunk
Exposure
  • In shared space with person with measles at the same time
  • or
  • In shared space vacated by person with measles within prior 2 hrs
  • Travel to area of local transmission
Immunization History
  • Number of MMRs and date received
  • Child considered non-immune until 2–3 wks after first MMR
Immunocompromise
  • Severe primary immunodeficiency
  • History of bone marrow transplant, current chemotherapy, solid organ transplant
  • HIV infection
  • Daily steroid therapy > 2 wks
 
 
Exposure to Measles or Travel to Area of Local Transmission
 
 
 
 
No measles symptoms
Measles symptoms
 
 
 
 
  • ≥ 12 mos and
  • ≥ 1 MMR and
  • Not immunocompromised
  • < 12 mos or
  • No MMR or
  • Immunocompromised
 
 
 
 
 
 

Expedite to Room

Point of Entry PPE Kit

Can return to waiting room

Standard Precautions
 
 
 
 
PPE N95, child Masking/Tenting
PHL ED
  • AIIR preferred, ED Rms 4, 14,15, 27, 28, 45, 46, 47, door closed
  • Non-AIIR ED Rm w/ door closed if no AIIR available
KOPH ED ED Rm 26, followed by 25, 24
 
 
Clinical Decision-Making for Measles Testing
 
 
 
 

No Measles Testing Recommended

Measles Testing Recommended
Call 5-SAFE Prior to Ordering Tests

  • NP Measles PCR
  • Urine Measles PCR
  • Rapid QUAD and Respiratory Viral Panel PCR as indicated
 
 
 
 
 
 
 
 
Discharge
Admit