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Measles Information For Providers

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How should providers report?

  1. Call Contra Costa Public Health immediately (24/7) to report all suspect, probable or confirmed cases of measles  (see table below for phone numbers) 
  2. In addition to calling, Complete the Contra Costa Public Health Measles Case History Form. Fax a copy of the completed form to Public Health at 925-313-6465. If fax isn't an option, the form can be sent via encrypted email to cococd@cchealth.org. 
 TIME  PHONE  NOTES
 Business hours (8 a.m. – 4:30 p.m., M-F excluding holidays)  925-313-6740  Communicable Disease Programs staff will answer.
 

After hours (including holidays) call CC Sheriff's Dispatch

  925-646-2441  Ask for the health officer on-call.

What can providers do?

Although initially thought to be eliminated in the United States in 2000, 2019 marked a measles (rubeola) resurgence in the United States.  Measles cases are expected to continue to rise due to decreased uptake in routine vaccinations and an increase in global incidence and domestic outbreaks.

Be aware of key risk factors for measles: 

  • Being unvaccinated or not fully vaccinated 

  • International travel and/or domestic travel to an area with a known outbreak

Consider measles in patients presenting with febrile rash illness and clinically compatible measles symptoms (cough, coryza, and conjunctivitis) with exposure history. 

Ask patients about travel internationally in the last 21 days prior to symptom onset or to domestic venues frequented by travelers, as well as history of measles in the community. Ask patients about visitors within the last 21 days prior to symptom onset from location with known measles outbreaks

Ensure that patients are up to date with all vaccinations, especially if traveling abroad. 

Testing

Should I test for measles?

Follow the steps in the Should I Test for Measles? guide.

Measles is typically characterized by high fever followed by a descending, maculopapular rash. Here are the symptoms to look for:

  • Measles usually begins with a high fever and one or more of the “3 Cs”: cough, coryza, conjunctivitis.
  • The rash develops after the fever and typically appears first on the face, along the hairline, and behind the ears and then spreads downward to the rest of the body.
  • The rash is erythematous and maculopapular, progressing to confluence in the same order as the spread of the rash.
  • Confluence is typically most prominent on the face.
  • The rash begins to clear on the third or fourth day in the same order as it appeared.
  • Fever typically peaks 2 to 3 days after rash onset.

How do I test for measles?

Lab testing is coordinated through the Contra Costa Public Health Laboratory. The lab will run a reverse-transcription polymerase chain reaction (RT-PCR) test.

First, report the suspected case to get approval for testing. Then, collect the appropriate specimens. You will need to collect both urine and a throat or nasopharyngeal swab

Collect specimens

Send specimens to Contra Costa Public Health Laboratory

Infection Control

If you suspect that your patient has measles, take the following steps:

  • Immediately mask and isolate the patient.
  • Place them in an Airborne Infection Isolation Room (AIIR) when available.
  • If an AIIR isn't available, examine them outside the facility or in a private room with the door closed.
  • Minimize the time the patient spends in the facility and in all common patient areas.

Other precautions apply. Learn more:

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