News & Views: Have You Ever Diagnosed Measles?
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Vaccine Update for Healthcare ProvidersPublished on
Vaccine Update for Healthcare ProvidersEditor’s Note: This article was originally published in the June 2014 issue of Vaccine Update. Given recent cases of measles and warnings about the spread of measles from the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO), we thought it was a good time to update and republish it.
Would you recognize a case of measles if an infected patient entered your office or clinical setting? Many younger clinicians today have never had to diagnose a patient with measles — an attestation to the effectiveness of the measles vaccine. Indeed, measles is one of the most contagious infectious diseases. It hangs in the air for a few hours after an infected person leaves the area, meaning that a person can spread the virus to people they never even come into physical contact with.
Measles can be confused with other illnesses, including Kawasaki disease, dengue and scarlet fever, among others, because of its common presentation as a rash accompanied by fever. When a patient has these symptoms, the following should also be considered to help distinguish measles from other possible illnesses:
Children presenting with measles typically appear to be miserable.
Measles is one of the most contagious diseases, spreading commonly, but not solely, via large droplets. The virus is so contagious that if a susceptible person occupies an elevator or other enclosed space up to two hours after a person infected with measles, he or she is likely to be infected. The period of highest contagion is four days before to four days after onset of rash. Because of this ease of spread, it is imperative to isolate infected patients from susceptible patients, such as those who are too young to be immunized. Methods for decreasing the chance of transmission in the waiting room include the following:
Current isolation precautions can be accessed on the CDC’s website.
Get a serum sample and either a throat or nasopharyngeal swab from the patient. A urine sample may also contain measles virus proteins, but throat or nasopharyngeal swabs are preferred over urine samples. The most common tests are an IgM test and a real-time polymerase chain reaction (RT-PCR) test; either of these can typically be used for laboratory identification of measles. The CDC has a comprehensive section on its website related to measles lab tests.
Suspected cases of measles should be reported to local public health officials as soon as feasible, and health departments are required to report cases to the CDC within 24 hours. Find out more about what information will be needed from the CDC’s surveillance manual.
The MMR vaccine should be given at 12 to 15 months of age with a second dose between 4 and 6 years of age as recommended on the approved immunization schedule. Measles outbreaks provide a compelling argument for choosing not to delay receipt of the MMR vaccine. Three studies provide additional reasons for children to be immunized as soon as they are of age:
For more information about measles, check these resources:
Looking for resources to share with families? Check these VEC resources:
Hearing misinformation about measles and the vaccine? SciCheck has addressed recent concerns that are circulating, “Posts Mislead About Measles, MMR Vaccine Amid Recent Outbreaks.”
Contributed by: Charlotte A. Moser, MS, Paul A. Offit, MD
Categories: News and Views About Vaccines, Vaccine Update February 2024
Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.
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