[KeyStoneChapter] Fwd: PDPH Advisory - Measles Infection Control, Testing, and Vaccination Guidance

Thu Jan 11 04:44:00 UTC 2024

FYI

Stacie

*Stacie Leap*
stacie.leap at gmail.com | 215.776.6741

---------- Forwarded message ---------
From: PDPH <health.notifications at phila.gov>
Date: Tue, Jan 9, 2024 at 4:06 PM
Subject: PDPH Advisory - Measles Infection Control, Testing, and
Vaccination Guidance
To: stacie.leap at gmail.com <stacie.leap at gmail.com>

The Philadelphia Department of Public Health has released a Health Advisory
regarding measles infection control, testing, and vaccination guidance. It
is available from https://hip.phila.gov, is appended to this email and is
attached as a PDF document. To read this attachment, you will need the
Adobe Reader software, which can be downloaded at no cost from
http://tinyurl.com/6ip.

If you have any questions or problems, please contact the Philadelphia
Department of Public Health at publichealthpreparedness at phila.gov.

To report a disease or condition to the Philadelphia Department of Public
Health, call 215-685-6748 during business hours (8:30AM to 5:00PM
Monday-Friday). If the disease or condition requires immediate notification
and it is after normal business hours, call 215-686-4514 and ask to speak
with the contact for the Division of Disease Control.

To update your contact information for the Health Alert Network or to
register to receive health alerts and newsletters from PDPH, reply directly
to this email or complete a registration form at
https://hip.phila.gov/health-alerts-subscriber-signup/.
------------------------------

Philadelphia Department of Public Health
*Health Advisory*
Measles Infection Control, Testing, and Vaccination Guidance
*January 9, 2024*

*Summary Points:*

   - Three secondary cases and 4 tertiary cases of measles have occurred
   locally in Philadelphia in the past month after exposure to an individual
   with an infection acquired internationally. All cases have been
   unvaccinated.
   - Have a high suspicion for measles in unvaccinated individuals with
   fever, congestion, and cough, even before the appearance of rash,
   especially if they have been notified that they are or a contact of theirs
   was exposed to measles.
   - Primary care providers should reach out to all individuals who are 12
   months and older and who are not up to date on vaccination to schedule MMR
   vaccination as soon as possible.

Three secondary cases of measles have occurred locally in Philadelphia in
the past month after exposure to an individual with an infection acquired
internationally. Four tertiary cases have occurred after exposure to one of
the secondary cases at daycare. Cases did not have previous immunity.

There have been multiple measles exposures at healthcare facilities in and
around Philadelphia as well as a daycare in Philadelphia. For a complete
updated listing visit this blog post.
<https://www.phila.gov/2024-01-04-health-department-cautions-philadelphians-about-recent-measles-cases/>

Efforts have been made by health care institutions as well as PDPH and
surrounding county and state health departments to contact individuals
exposed. Since not all individuals are able to be reached or identified, it
is possible that additional local transmission of measles may occur
particularly among persons who lack measles immunity.

*Infection Control*

   - Maintain a high suspicion for measles in individuals who are not
   immune and present with measles symptoms.
   - Create triage policies to quickly identify patients who could have
   measles including questions about recent measles exposures and symptoms. If
   possible, consider preliminary triage at the door.
   - Immediately place individuals who may have measles in airborne
   infection isolation rooms (AIIR). If an AIIR isn’t available, the patient
   should be placed in a single room and must mask until they can be placed in
   an AIIR. Measles spreads between rooms through shared airspace. All staff
   should don a respirator.
   - Consult with engineering teams to determine the best locations to
   place patients if all AIIR are occupied.
   - Outpatient providers should notify hospital emergency rooms (ER) prior
   to referring patients to present to the ER so that patients can be quickly
   isolated. Patients age 2 and over should be told to mask when presenting to
   the ER. Providers should also contact PDPH by calling 215-685-6741 for any
   suspect cases.

*Testing*

   - Contact PDPH by calling 215-685-6741 during regular business hours or
   215-686-4514 after hours and on weekends if you suspect a measles case and
   to coordinate testing. Healthcare facilities that are located outside of
   Philadelphia should contact their local health departments to coordinate
   testing. Test concurrently for other respiratory viruses.
   - Providers should collect an NP swab in viral or universal transport
   media and urine specimen in a sterile container (minimum 50 ml) for measles
   PCR. Refrigerate if specimens are not transported or shipped immediately.
   Ship on cold packs. PCR is sent through the state Bureau of Laboratories.
   While PCR testing is available commercially, results will not be received
   in a timely manner.
   - Consider sending measles IgG serology through commercial labs for
   individuals who don’t have documentation of measles immune status and are
   potential contacts. This will help avoid a quarantine if positive but
   should be done in the first 5 days after exposure and before an individual
   would become potentially infectious. PDPH may be able to help coordinate a
   home blood draw after that time if necessary, so that healthcare exposures
   can be avoided.

*Vaccination*

   - Administer routine and catch-up vaccination with measles, mumps, and
   rubella (MMR) vaccine.
   - Recall patients 12 months and older who are not up to date on MMR
   vaccination.
   - Primary care offices could consider nurse only clinics or other
   strategies to bring children in quickly for their first MMR vaccine.
   - Individuals who have received only 1 MMR greater than 28 days ago and
   are exposed should receive a 2nd dose within 72 hours of exposure.
   - MMR is also recommended for infants 6-11 months of age before
   international travel.
   <https://www.cdc.gov/vaccines/vpd/mmr/public/index.html>

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