Measles Testing Guidance for Patients Tested at Children's Mercy

• PCR testing has the highest yield in the first 3 days from the onset of rash and decreases over time. The yield of IgM testing increases 3 or more days after the onset of the rash.
• Obtain all laboratory tests in the patient’s room.
• For Children's Mercy physicians or nurse practitioners, all locations (including those in Kansas):
  • Contact the Missouri Department of Health to request approval for testing:
    • MO Dept. of Health: 573-751-6113 or 800-392-0272 (after hours)
    • During the call, obtain the name of the state test approver to enter the order
  • Order a Ref Lab Misc Test- Measles RT-PCR in Cerner, specimen type/source: nasopharyngeal (NP) or oropharyngeal (OP)
  • Order Measles (Rubeola) Antibodies, IgM- Use lab collection instructions 
  • Collect NP or OP swab in Universal Transport Media (UTM) 
  • Send NP/OP swab and serum sample with appropriate labeling through the typical processes
  • Email LabSendouts@cmh.edu with the Patient’s name, MRN, DOB, and name of state test approver
    • The Send Out lab will fill out the MO state lab test requisition form 

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.