Measles Reported in Idaho

A patient with confirmed measles has been reported in an unvaccinated adult resident of southwest Idaho who was exposed during recent international travel.

This person with measles spent time at the Boise airport on September 13 during their infectious period, and in the Nampa area on September 14-15.

Investigation is ongoing, and possibly exposed people are being notified by the local public health district; however, it is possible that some people who were exposed would not have been identified by public health officials; vigilance for this highly infectious disease is critical.

Providers are reminded to:

• Consider measles infection in exposed patients with compatible symptoms, including:
  • Prodrome of fever, cough, coryza, and conjunctivitis for 2-4 days
  • Generalized maculopapular rash that usually begins on the face at the hairline and then spreads to the neck, trunk, and extremities
  • Koplik spots may appear on buccal mucosa 1-2 days prior to rash
• Be prepared for the possibility of patients with measles at your facility. Infection prevention and control specialists with the Idaho Division of Public Health, Healthcare Associated Infections Program are available at 208-334-5871.

In urgent/emergency healthcare settings:

• Patients with suspected measles should wear a mask covering the nose and mouth and be triaged immediately away from waiting rooms, in airborne isolation if available.

In outpatient clinic settings:

• Schedule suspected measles patients to be seen at end of day, if possible, and keep them out of waiting rooms
  • Use standard and airborne infection control precautions
  • Only staff with documented immunity to measles should enter patient’s room
  • After the suspect patient is discharged, do not have additional patients or staff enter the room for 2 hours.

All healthcare settings:

• Healthcare personnel should use respiratory protection (i.e., a respirator) that is at least as protective as a fit-tested, NIOSH-certified, disposable N95 filtering facepiece respirator, regardless of presumptive evidence of immunity, upon entry to the room or care area of a patient with known or suspected measles.
• Collect specimens on patients with suspected measles for diagnostic PCR testing:
  • Throat, nasal, or nasopharyngeal swab (Dacron with plastic or aluminum shaft) placed in 1-3mL of Viral Transport Medium (VTM) or Universal Transport Medium (UTM). 
  • Keep the sample at 2-8°C and transport or ship on cold packs.  Note: swabs with calcium alginate or cotton tips and wooden shafts are unacceptable.
• Route specimens through Public Health to expedite testing. The Idaho Bureau of Laboratories (208-334-2235) can provide PCR for measles testing.
• Report suspected cases of measles to Public Health immediately before discharging or transferring patients. During business hours, Central District Health at 208-327-8625 or the Division of Public Health Epidemiology Section at 208-334-5939. After hours call the State Communications Center at 1-800-632-8000 and ask that local public health and the state public health laboratory be contacted for assistance.

Resources:

Idaho Bureau of Laboratories: https://healthandwelfare.idaho.gov/providers/idaho-laboratories-and-testing/idaho-bureau-laboratories

Idaho Healthcare Associated Infections Program: https://healthandwelfare.idaho.gov/providers/infection-prevention-and-control-antibiotic-resistance-and-antimicrobial-stewardship

Idaho Public Health Districts: https://healthandwelfare.idaho.gov/health-wellness/community-health/public-health-districts

U.S. Centers for Disease Control and Prevention: https://www.cdc.gov/measles/hcp/index.html

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