Be aware of a confirmed measles case in an infant.The infection was likely acquired while traveling outside the United States.

• Assess patients with measles symptoms for recent international travel, exposure at a King County exposure location (see below), or potential exposure to a confirmed measles case.
  
• Consider measles infection in patients with compatible symptoms, including:
  
  • Prodrome of fever, cough, coryza and conjunctivitis lasting 2–4 days
    
  • Generalized maculopapular rash that usually begins on the face at the hairline and spreads downward to the neck, trunk, and extremities
    
  • Koplik spots may appear on buccal mucosa 1–2 days prior to rash
    
• Instruct reception/triage staff to identify patients who present with symptoms of possible measles
  
  • Patients with symptoms of measles should wear a mask covering the nose and mouth and should be kept away from patient waiting rooms.
    
  • Room the patient immediately and close the door.
    
  • Only staff with documented immunity to measles should be allowed to enter the patient's room.
    
  • After the patient is discharged, do not use the room for 2 hours.
    
• Report suspected cases of measles to Public Health at (206) 296-4774 immediately before discharging or transferring patients.
  
• Collect specimens on patients with suspected measles:
  
  • Nasopharyngeal swab (preferred respiratory specimen) for PCR and virus isolation
    
  • Urine (at least 50 ml) for PCR and virus isolation
    
  • Serum (at least 1 ml) for measles IgM
    
• Route laboratory specimens through Public Health at (206) 296-4774 to expedite testing, do not use a commercial laboratory.