Measles outbreak in southwest Washington

Actions requested

• Be aware of an active measles outbreak investigation being conducted by Clark and Wahkiakum Counties.
• As of January 10, 2024, 3 lab-confirmed and 3 epi-linked measles cases have been identified among unvaccinated adults.
• No known public exposure locations have been identified.
• Consider measles infection in patients with compatible symptoms, including:
• Prodrome of fever, cough, coryza and conjunctivitis for 2-4 days.
• Generalized maculopapular rash that usually begins on the face at the hairline and then spreads to the neck, trunk, and extremities.
• Koplik spots may appear on buccal mucosa 1-2 days prior to rash.
• Be prepared for possible measles cases at your facility:
• Patients with suspected measles should wear a mask covering the nose and mouth.
• In urgent/emergency healthcare settings:
• Suspected patients should be triaged immediately away from waiting rooms
• Room patient in airborne isolation if available.
• In outpatient clinic settings:
• Schedule suspected patients to be seen at end of day, if possible, and keep them out of waiting rooms.
• Use standard and airborne infection control precautions.
• Only staff with documented immunity to measles should enter patient’s room.
• After patient is discharged, do not use or have staff enter the room for 2 hours.
• Collect specimens on patients with suspected measles for diagnostic testing:
• For PCR and virus isolation:
• Nasopharyngeal swab placed in viral transport media (VTM)
• Urine, minimum 20mL, in sterile leak proof container
• For measles IgM serology:
• Serum, minimum 1mL, in red top or red-grey top tube
• Route specimens through Public Health to expedite testing (do not use commercial laboratory).
• Assess immunization status of patients at every visit and strongly recommend vaccination based on recommended schedule, health condition, occupation, and other risk factors such as travel; Under-vaccinated individuals may be at risk for measles infection due to outbreaks that occur in the US or anywhere else in the world.
• Report suspected cases of measles to Public Health at (206) 296-4774 immediately before discharging or transferring patients.