Increase in Measles Cases and Outbreaks: Ensure Children in Massachusetts and Those
Traveling Internationally 6 Months and Older are Current on MMR Vaccination
On March 18, 2024, CDC issued a Health Alert Network (HAN) Health Advisory to alert health providers to the global and domestic increase in measles cases and to provide recommendations about how to reduce the occurrence of new measles cases and outbreaks in the US.
Full Health Alert Network Advisory: Here
Recommendations for Healthcare Providers
- Schools, early childhood education providers, and healthcare providers should work to ensure students are current with MMR vaccine
https://www.cdc.gov/vaccines/vpd/measles/index.html
- Children who are not traveling internationally should receive their first dose of MMR at age 12 to 15 months and their second dose at 4 to 6 years.
- All U.S. residents older than age 6 months without evidence of immunity who are planning to travel internationally should receive MMR vaccine prior to departure.
- Infants aged 6 through 11 months should receive one dose of MMR vaccine before departure. Infants who receive a dose of MMR vaccine before their first birthday should receive two more doses of MMR vaccine, the first of which should be administered when the child is age 12 through 15 months and the second at least 28 days later.
- Children aged 12 months or older should receive two doses of MMR vaccine, separated by at least 28 days.
- Teenagers and adults without evidence of measles immunity should receive two doses of MMR vaccine separated by at least 28 days.
- At least one of the following is considered evidence of measles immunity for international travelers: 1) birth before 1957, 2) documented administration of two doses of live measles virus vaccine (MMR, MMRV, or other measles-containing vaccine), or 3) laboratory (serologic) proof of immunity or laboratory confirmation of disease.
- Consider measles as a diagnosis in anyone with fever (≥101°F or 38.3°C) and a generalized maculopapular rash with cough, coryza, or conjunctivitis who has recently been abroad, especially in countries with ongoing outbreaks. https://www.cdc.gov/globalhealth/measles/data/global-measles-outbreaks.html
When considering measles, then:
- Isolate: Do not allow patients with suspected measles to remain in the waiting room or other common areas of a healthcare facility; isolate patients with suspected measles immediately, ideally in a single-patient airborne infection isolation room (AIIR) if available, or in a private room with a closed door until an AIIR is available. Healthcare providers should be adequately protected against measles and should adhere to standard and airborne precautions when evaluating suspect cases, regardless of their vaccination status. Healthcare providers without evidence of immunity should be excluded from work from day 5 after the first exposure until day 21 following their last exposure. Offer testing outside of facilities to avoid transmission in healthcare settings. Call ahead to ensure immediate isolation for patients referred to hospitals for a higher level of care.
https://www.cdc.gov/vaccines/vpd/mmr/public/index.html
- Notify: Immediately notify state, tribal, local, or territorial health departments (24-hour Epi On Call contact list) about any suspected case of measles to ensure rapid testing and investigation. States report measles cases to CDC.
- Test: Follow CDC’s testing recommendations and collect either a nasopharyngeal swab, throat swab, and/or urine for reverse transcription polymerase chain reaction (RT-PCR) and a blood specimen for serology from all patients with clinical features compatible with measles. RT-PCR is available at many state public health laboratories, through the APHL Vaccine Preventable Disease Reference Centers, and at CDC. Given potential shortages in IgM test kits, providers should be vigilant in contacting their state or local health department for guidance on testing.
- Manage: In coordination with local or state health departments, provide appropriate measles post-exposure prophylaxis (PEP) as soon as possible after exposure to close contacts without evidence of immunity, either with MMR (within 72 hours) or immunoglobulin (within 6 days). The choice of PEP is based on elapsed time from exposure or medical contraindications to vaccination."
Recommendations for Parents and International Travelers
- Even if not traveling, ensure that children receive all recommended doses of MMR vaccine. Two doses of MMR vaccine provide better protection (97%) against measles than one dose (93%). Getting MMR vaccine is much safer than getting measles, mumps, or rubella.
- Anyone who is not protected against measles is at risk of getting infected when they travel internationally. Before international travel, check your destination and CDC’s Global Measles Travel Health Notice for more travel health advice, including where measles outbreaks have been reported.
- Parents traveling internationally with children should consult with their child’s healthcare provider to ensure that they are current with their MMR vaccinations at least 2 weeks before travel. Infants aged 6 to 11 months should have one documented dose and children aged 12 months and older should have two documented doses of MMR vaccine before international travel. Depending on where you are going and what activities you plan, other vaccines may be recommended too.
- After international travel, watch for signs and symptoms of measles for 3 weeks after returning to the United States. If you or your child gets sick with a rash and a high fever, call your healthcare provider. Tell them you traveled to another country and whether you or your child have received MMR vaccine.
ITEM LIVE
Influenza a potential cause of bird deaths in Nahant
March 12, 2024 by Benjamin Pierce
Link to Article: https://itemlive.com/2024/03/12/influenza-a-potential-cause-of-bird-deaths-in-nahant/
