Information for Health Care Providers

This webpage includes measles information for health care providers about minimizing exposure, initial infection control procedures, treating patients, and testing.

Find information about the current outbreak on the DSHS website.

More measles resources for health care providers are available at the bottom of the page.

If possible, health care providers should prepare in advance to treat patients with suspected or confirmed cases, including to:

• Ensure health care personnel have presumptive evidence of measles immunity. Acceptable presumptive evidence of measles can be found on the CDC website.
• Have a plan for how your facility will:
  • Appropriately manage exposed and ill health care personnel.
  • Quickly identify and isolate patients with known or suspected measles.
  • Adhere to standard and airborne precautions for people with known or suspected measles.
• Routinely promote and facilitate respiratory hygiene and cough etiquette, and provide:
  • Face masks to people with respiratory symptoms or close contact exposure.
  • Alcohol-based hand sanitizer dispensers.
  • Tissues and no-touch receptacles to dispose of used tissues.
  • Hand washing supplies at sinks, where applicable.

Visit the CDC Interim Infection Prevention and Control Recommendations for Measles in Health care Settings webpage for more information.

Initial Infection Control Procedures

Screen all patients, visitors, and health care personnel for measles signs and symptoms. If a person with suspected or confirmed measles comes to your facility, immediately mask and isolate the person in a single-patient airborne infection isolation room (AIIR). If an AIIR is not available, temporarily use a private room with a closed door until the person can be transferred to an AIIR. Persons with suspected measles should not be in the waiting room or other facility common areas.

Follow standard and airborne precautions. After the person leaves the room, it should be vacant for at least two hours.

Staff interacting with people with a suspected or confirmed measles case should wear a NIOSH-approved, fit-tested N95 respirator. Ensure that only staff with presumptive measles immunity evidence care for suspect or confirmed measles cases. Health care providers with no evidence of measles immunity who are exposed to measles should be excluded from work from day five after the first exposure until day 21 after the last exposure and offered post-exposure prophylaxis, as appropriate.

CDC Resources for more information on infection control procedures:

• Interim Infection Prevention and Control Recommendations for Measles in Health Care Settings
• Measles Infection Control Recommendations in Health Care Personnel

There are some scenarios where the MMR vaccine or immune globulin are recommended as postexposure prophylaxis (PEP):

Measles is an immediately notifiable condition. If a provider suspects measles, please notify the local or regional health department immediately, preferably while the patient is in your presence, and collect a specimen for testing. Offering measles testing outside of facilities can reduce the likelihood of transmission in health care settings. If the person is in the facility, isolate them as part of initial infection control procedures and contact your local public health department while the person is still isolated.

If an acute infection with measles is suspected, collect a throat swab for reverse transcriptase polymerase chain reaction (RT-PCR). RT-PCR is the recommended test for testing suspected acute measles cases; serology is not recommended because serology may produce false positives in vaccinated people.

Texas DSHS Laboratory Virology Specimen Submission

If there is a high suspicion of measles, the DSHS preference is to test at the DSHS Laboratory or the Lubbock LRN. Testing must be coordinated with your local health department or public health region.

To process labs at the DSHS Laboratory, submitters must:

1) Have a “submitter ID number;”

2) Follow the required collection and storage instructions detailed on the DSHS website; and

3) Have pre-approval from the DSHS Laboratory. If your lab is pre-approved to submit to the DSHS Laboratory, include the DSHS G-2V “Virology Specimen Submission Form,” available on the DSHS Laboratory forms webpage. If you are not using the DSHS Laboratory for testing, follow your chosen lab’s submission requirements.

To obtain an established submitter ID, complete the “Submitter ID Request Form” (using this link: Submitter ID Request Form) and either email it to LabInfo@dshs.texas.gov or fax it to 512-776-7533. In one to three days, a submitter ID will be emailed to you, and then you can take next steps to test for measles.

Additional Information About Ordering/Requesting DSHS Laboratory Measles Testing

The DSHS Laboratory has limited specimen testing capacity, so submitters need prior approval for measles testing. Timing for approvals should be relatively quick when the submitter provides complete information.

Specimen testing criteria requests are assessed by the local health department who may require you to report:

1. Symptoms
2. Symptom onset date
3. If there is a rash present (and rash type)
4. Where the rash started on the body
5. Any recent antibiotic use/medication change
6. Any other diagnosis/illness that could explain the symptoms
7. Travel history
8. Vaccine history
9. Any contact with a confirmed or suspect measles case

If the specimen does not meet DSHS Laboratory testing criteria, the recommendation is to test through a commercial lab, which may have a slower turnaround time. DSHS understands that there may be barriers, so if commercial testing is unavailable, inform the local health department when you speak to them about requesting specimen testing.

Measles Testing Resources:

• Frequently Asked Questions
• Microbiology Specimen Submission Job Aids
• Measles | Texas DSHS

The measles vaccine is highly effective at preventing measles infection. Two doses are recommended, the first at 12 to 15 months of age, and the second at 4 to 6 years. The vaccine protects 93 percent of people after one dose and 97 percent of people after two doses given on schedule. In areas where measles is actively spreading, an early dose may be given to protect infants between 6 and 12 months of age. The child should still get two additional doses on schedule to ensure long-lasting protection.

Find more information for providers in the CDC’s Routine MMR Vaccination Recommendations.