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West Region
November 16, 2022
Measles: No longer a Zebra (Diagnosis)?

Decreased vaccination rates associated with the pandemic have led to an increase in international cases of measles over the past year. Individual cases within the United States and Ohio have previously been linked to travelers who brought measles back from other countries where outbreaks are occurring.  However, a measles outbreak has been declared in the Columbus area due to evidence of ongoing community transmission of measles (Public Health Advisory available at here). Measles is a highly infectious virus transmitted via respiratory droplets and airborne spread. Clinical presentation includes cough, coryza or conjunctivitis, fever and maculopapular rash. Children’s Hospital Division of Infectious Disease advises that all healthcare personnel should have documented evidence of measles immunity. In addition to encouraging routine childhood immunization with MMR vaccine, you may also consider recommending that infants as young as 6 months of age receive one dose of MMR prior to international travel, however be aware that any MMR vaccine dose given between 6-11 months of age does not count toward a child’s primary MMR vaccine series.  Finally, if you have a patient whom you suspect may have measles, promptly mask the patient and don a fit-tested N-95 mask or PAPR. Isolate the patient to an Airborne Infection Isolation Room or if none exist in your clinic setting, in a private room located in a low-traffic area. Contact your local health department regarding testing recommendations and additional information. Typically, a nasopharyngeal or throat swab will be required (transported in viral transport media) along with a serum red top sample. Here are some additional links from the Centers for Disease Control and Prevention and the Ohio Department of Health with more information:

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