Infection Prevention & Control Recommendations to Minimize Measles Exposure

• Upon arrival and patient placement:
  • Provide face masks for patients (2 years of age and older) and family before they enter the facility. Patients unable to wear a mask should be “tented” with a blanket or towel when entering the facility.
  • Immediately move the patient and family to a private exam room, ideally an airborne infection isolation room (AIIR) or negative pressure room. If AIIR is unavailable, use a private room with a closed door.
  • No other children should accompany a child with suspected measles.
  • Patients (2 years of age and older) and family should leave the mask on if feasible for the duration of the visit.
• Healthcare personnel (HCP):
  • Only HCPs with evidence of immunity should provide care, unless no other HCP is available.
• Isolation precautions and PPE:
  • Standard and airborne precautions should be followed.
  • HCP should use a PAPR or a fit-tested N95 mask.
• Transporting patients:
  • Limit transport of patients unless medically necessary.
  • If transport is necessary, the patient should wear a facemask.
• Room closure: 
  • After the patient leaves a negative pressure room, it should remain vacant for at least 1 hour.
  • After the patient leaves a standard exam room, it should remain vacant for at least 2 hours.
  • Refer to the air changes/hour document, Appendix B. Air | Infection Control | CDC. 
• Cleaning procedures:
  • Standard cleaning and disinfection are adequate.
• Duration of quarantine: 
  • Asymptomatic patients with measles exposure without evidence of immunity should quarantine based on their local health department recommendations, typically between 21 and 28 days from the exposure.
• Duration of isolation precautions:
  • Patients with confirmed measles who are discharged should isolate at home for 4 days after the onset of the rash (rash onset is considered day 0).
  • Patients with measles in healthcare settings should remain in airborne precautions for 4 days after the onset of the rash (rash onset is considered day 0). Immunocompromised patients should remain in airborne precautions for the duration of illness. 

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.