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A health care worker (HCW) who has been exposed to measles may
continue to work if the HCW:
a) Was born before 1957
b) Has received post-exposure prophylaxis due to possible
measles susceptibility
c) Has documentation of receiving 2 doses of the
measles, mumps and rubella (MMR) vaccine
d) Has documentation of laboratory evidence of
measles immunity (measles IgG positive)
e) Has laboratory confirmation of disease from
prior to the exposure
As you have likely heard, Minnesota is experiencing the
largest measles outbreak in years. At this writing, 76 cases of measles have been confirmed in
Minnesota as a part of this outbreak. Measles is highly contagious among
susceptible people and can lead to serious complications. The presence of
measles in a facility requires a quick and thorough response to make sure
appropriate precautions are put in place and that follow up is carried out to
minimize risk for exposed individuals.
The specific health care setting will determine what steps
need to be taken. The following are some standard measures for measles:
- Maintain situational awareness. Know what
infectious diseases are circulating in your community and beyond.
- Screen patients/residents for signs and symptoms
of infection as well as relevant exposures and recent travel.
- Ensure to the extent possible that staff have
documentation of 2 doses of MMR vaccine or lab evidence of immunity.
- Have a plan in place for how you will handle a
suspect case. This includes having appropriate personal protective equipment on
hand and determining whether your facility has a suitable isolation room for
the patient or if they will need to be transferred to another facility.
Measles is immediately reportable to MDH by phone at 651-201-5414
or 1-877-676-5414. MDH will provide follow-up on exposed individuals and is
available to answer your questions about measles or any other communicable
diseases. Visit the MDH website for more information on how to Minimize
Measles Transmission in Health Care Settings.
MMR vaccine is packaged in single-dose vials. What does that
mean? A single-dose vial is approved for use on a single patient for a single
injection or procedure. Single-dose vials lack a preservative. Because live
virus MMR vaccine does not contain a preservative, harmful bacterial growth
potential increases once the vial is opened. Once you have reconstituted the
vaccine with the correct diluent, withdraw the dose of vaccine into a syringe
and immediately dispose of the vial. Leftover medication cannot be saved for
later use and must be discarded. Find more information about single-dose and
multi-dose vials at the One &
Only Campaign website.
The American Society of Nephrologists has teamed up with CDC
in a new initiative to prevent infections and improve the quality of care among
dialysis patients. Nephrologists Transforming Dialysis Safety (NTDS) aims to
engage nephrologists in promoting best practices for infection prevention. As
part of this initiative, NTDS provides education and training, and collaborates
with key stakeholders. NTDS just
launched their new website, where you can find resources such as educational
opportunities on infection prevention and other quality improvement measures
for all members of the nephrology care team.
Answer: c, d, and e. Only HCWs who have documentation of receiving
2 doses of MMR vaccine, serologic evidence of measles immunity, or laboratory
confirmation of measles disease should be allowed to continue to work in a
clinical setting from 5 days through the 21st day following measles exposure.
While
most people born before 1957 are immune to measles, immunity is not guaranteed.
Exclusion is recommended for exposed HCWs born before 1957 without
documentation of 2 MMR or serologic evidence of immunity, regardless of whether
they have received post-exposure vaccine or immune globulin.
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