For Clinicians
Measles Situation Update
5/31/2019
Alameda County:
- A case of measles was confirmed in a Berkeley resident the week of 5/13/19. The City of Berkeley Public Health Department issued a public notification, and led the public health response while coordinating closely with the Alameda County Public Health Department.
- No other significant public exposures to measles have been identified within Alameda County.
- ACPHD continues to work with the health care community to be alert for new cases in the county and is prepared to quickly respond to any new exposures or cases.
- Measles Immunization for Adults
California & U.S.:
- The United States has the highest number of cases in 2019 since measles was eliminated in 2000
- For more information, including guidance updates and California case counts, visit the CDPH measles website
Resources for Healthcare Providers
- Testing guide for California healthcare providers - May 2019 (CDPH)
- Summary of current recommendations on measles immunizations – May 22, 2019 (CDPH)
- Measles Recommendations - April 18, 2019 (CDPH)
- California Health Advisory - March 29, 2019 (CDPH)
- Recommendations for Measles Case Identification, Measles Infection Control, and Measles Case and Contact Investigations - April, 19 2019 (CDPH)
- Measles Clinical Guidance - April 2019 (CDPH)
- Health Care Facility Infection Control Recommendations for Suspect Measles Patients - April 2019 (CDPH)
Infection Control
Patients with suspected measles should be placed in an Airborne Infection Isolation Room immediately, if possible. Healthcare workers who enter the room of a suspected measles patient should have documented immunity (2 doses MMR or laboratory evidence of immunity by measles IgG) and should use a N95 respirator or higher level of protection. Never send a patient with suspected measles to an outside laboratory for testing; consult and coordinate with Alameda County Public Health Department. If higher level of care is necessary, mask the patient and notify receiving location of the patient’s suspected diagnosis. Note the times and locations where the patient was present, and obtain the names of all staff, patients, and visitors who were in those locations during the time the suspect measles patient was in the facility and for one hour after the patient left.
- Infection Control Guidance – April 2019 (CDPH)
- Measles Healthcare Exposure Quicksheet – May 2019 (CDPH)
Report Suspected Cases and Coordinate Training
Suspected measles cases should be reported to ACPHD by phone as soon as possible, and while the patient is still present if possible. M-F 8:30AM-5PM: (510) 267-3250; after-hours: (925)422-7595.
The Alameda County Public Health Laboratory will perform measles PCR testing on respiratory swabs and urine with approval from the ACPHD Acute Communicable Disease Unit (contact info above).
Do not use commercial laboratories for suspect measles cases.
- Measles Clinical Guidance: Identification and Testing of Suspect Measles Cases April 2019
- Measles Laboratory Testing Guidance (CDPH)
- Disease Reporting at ACPHD
MMR Vaccination
- Immunization Schedules for Adults and Children (CDC)
- Advisory Committee on Immunization Practices (ACIP) for MMR Vaccine (ACIP/ CDC)
- Multiple tools from CDC on how to Communicate about MMR Vaccine (CDC)
- Guide to help determine adult vaccine history (ACPHD)
- Measles Vaccine as Post Exposure Prophylaxis (CDPH Measles Investigation Quicksheet)
MMR Vaccination for Healthcare Providers
Healthcare personnel should have documented evidence of immunity against measles, according to the recommendations of the Advisory Committee on Immunization Practices
Health care providers who are exposed to a measles case may not go to work until they provide ACPHD with written documentation that they have received at least two doses of MMR or a serologic test showing measles immunity.
MMR Vaccine Storage and Handling
Immunization Referral Sites for Uninsured or Underinsured Patients
Many local clinics, pharmacies, or sites found on this vaccine locator website offer MMR vaccine for a fee. The patient should call before going to any of these sites for age limitations, availability, and cost
Other Resources for Clinician Education and Training
- Measles information for Healthcare Professionals (CDC)
- The Epidemiology and Prevention of Vaccine Preventable Diseases: Chapter on Measles (CDC)
- Vaccine information Statement (CDC)
- Immune Globulin for Measles Postexposure Prophylaxis (CDPH)
- Posters and Multi-Media in multiple languages (EZIZ)
- Provider Resources for Vaccine Conversations with Parents (CDC)