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

Active Measles in the Community
Measles Symptoms
  • Fever plus > 1 of the following:
    • Bilateral conjunctivitis
    • Rash on face, neck, trunk within 24 hrs of fever
Exposure
  • In shared space with infectious measles patient at the same time
  • or
  • In shared space vacated by infectious child within prior 2 hrs
Immunocompromise
  • Severe primary immunodeficiency
  • History of bone marrow transplant, current chemotherapy, solid organ transplant
  • HIV infection
  • Daily steroid therapy > 2 wks
  • ≥ 1 MMR
  • No immunocompromise
  • Age < 12 mos
  • Unimmunized
  • Unknown immunization
  • Immunocompromised
  • Exception:
    • Healthy
    • Measles symptoms
    • Exposed
    • 1 MMR
  • Exposed and/or
  • Measles Symptoms Present
Expedite to Room
  • 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
Documenting Isolation In Epic
No Symptoms No measles testing recommended
Symptoms
  • Call 5-SAFE prior to ordering tests
  • If testing indicated ensure both studies sent, confirm receipt by lab prior to discharge
Discharge
Admit
  • As clinically indicated
  • AIIR or single room w/door closed
  • Airborne precautions
Posted: August 2023
Last Revised: June 7, 2024
Editors: Clinical Pathways Team