Measles Outbreak in Several States
Several states including Washington, New York, and Illinois have on going measles outbreaks.This serves as a good reminder that we continue to ensure that all patients are protected. The measles-mumps-rubella (MMR) vaccine is the best way to protect individuals. Two doses of MMR vaccine provide 97% protection against measles.
The first dose of MMR should be given on or after the first birthday. A second dose of MMR is recommended to produce immunity in those who failed to respond to the first dose. The second dose of MMR vaccine should routinely be given at age 4-6 years, before a child enters kindergarten or first grade. The second dose of MMR may be administered as soon as 4 weeks (28 days) after the first dose.
Action Steps for Clinicians To Prevent Measles
- Health care providers should ensure that all personnel, including non-clinical staff and volunteers, have documented immunity to measles. Evidence of immunity for all health care personnel includes:
- Two doses of measles-containing vaccine (e.g. MMR)
- Laboratory evidence of immunity
- Laboratory confirmation of measles disease
- Birth before 1957. In an outbreak situation, personnel who lack proof of immunity should receive 2 doses of MMR, separated by at least 28 days, unless evidence of serologic immunity is demonstrated.
- Reinforce the importance of MMR vaccination by giving a strong recommendation to all patients.
- Use reminder/recall. Clinics can generate reports in the Wisconsin Immunization Registry (WIR) or your electronic health record system to determine which patients are due or overdue for MMR. Clinics can reach out to patients to schedule an appointment for immunization.
- Do not miss opportunities to vaccinate patients. Use every clinical encounter to assess and offer MMR.
- Place educational material in waiting and exam rooms, or add a pre-recorded message to the phone system. The CDC has many resources, such as MMR vaccine: What you should know.
Measles Vaccine Recommendations
Please continue to follow the recommended immunization schedule for age-appropriate vaccination. Parents and clients may view their vaccine record through the Wisconsin Immunization Registry public portal.
Reporting Suspect Measles
All measles cases-suspected or confirmed- must be reported to the Wisconsin Division of Public Health. Measles is a Wisconsin Disease Surveillance Category I disease. Health care providers who have patients with suspected or confirmed measles should report immediately by telephone to the patient’s local health department. The local health department shall then notify the state epidemiologist immediately by calling 608-258-0099.
The recommended specimen collection and laboratory testing are as follows:
- Combined throat and nasopharyngeal swabs for PCR, preferably within the first three days of illness, but no later than ten days after rash onset.
- Acute serum for IgM and IgG serology obtained as soon after onset as possible.
If you have questions regarding individuals who may have been exposed or who are experiencing symptoms, please call the Wisconsin Immunization Program at 608-267-9959.
For additional details, please visit the Wisconsin Division of Public Health Measles’s webpage.
Resources for school aged-children
The following materials can be used to share with parents of school aged children:
Measles fact sheet from the Wisconsin Division of Public Health
Top things parents need to know in English and in Spanish
Measles Information from the CDC for printing, websites, e-newsletters, etc.
2019 Vaccine Storage and Handling Guide
The CDC Vaccine Storage and Handling Guide 2019 has been published. This guide provides the best practices by which vaccine should be handled. Clinic staff who manage vaccines should review this guide.
Upcoming Webinar
Wednesday, February 13, 2019 from 1:00-2:00 p.m. CST
The Public Health Foundation (PHF) is presenting a webinar featuring immunization experts from the Centers for Disease Control and Prevention (CDC), called Perspectives on Oropharyngeal Cancer: Scientific Overview, Clinical Expertise, and Personal Experience, on Wednesday, February 13, 2019 from 1:00-2:00 p.m. central time.
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