Measles, Suspected Exposure or Infection — Guidance for Healthcare Providers — Clinical Pathway

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

Measles Exposures in Unimmunized, Underimmunized, or Immunocompromised Patients: Guidance for Healthcare Providers

Identify as Not At-Risk?

  • Two doses of MMR vaccine after 12 mos of age, or
  • Born 1957 or earlier, or
  • Documented positive measles IgG serology
  • and
  • Not severely immunocompromised

If a patient is not at risk, no special treatment is warranted.

Actions for Exposed and At-Risk Patients
(See AAP Red Book for in-depth discussion)

Infants < 6 mos
  • If within 6 days of exposure, give measles immunoglobulin
  • Home quarantine for 28 days from exposure
Infants 6 mos to 12 mos
  • If within 72 hours of exposure, give MMR
    (still will warrant 2 vaccines after 12 months)
  • If > 72 hours but < 6 days of exposure give measles immunoglobulin
  • Home quarantine for 21 days from exposure
    (28 days if given immunoglobulin)
Infants and Adults 1 yr,
No MMR Ever Given
  • If within 72 hours of exposure, give MMR
  • Home quarantine for 21 days from exposure
Infants 1 yr to 4 yrs,
1 MMR Previously Given		 If within 72 hours of exposure but > 28 days from previous MMR, give MMR
Infants and Adults > 4 yrs,
1 MMR Previously Given		 Give MMR
Immunocompromised Children and Adults Per AAP Red Book guidance or via consultation with medical home and infectious diseases expert

Infection Control Considerations for Office Visits

  • Use text and phone communication to minimize time in waiting or registration
  • Minimize number of people accompanying patient to office
  • Keep exam room door closed
  • Patients and family should wear masks and follow good hand hygiene
  • Medical providers should be fully immunized and use masks, gloves, gown
  • Symptomatic patients should only be seen in ED setting – please notify ED of patient referral, and provide patient’s contact information, to allow preparation