Over the past few years, the BCU team has learned the importance of taking a good travel and social history. The current measles outbreak is a great reminder of the importance of asking about our patients’ lives, activities and the places they travel.
As of April 19, 2019 the Centers for Disease Control and Prevention reported the U.S. has seen 626 individual cases of measles confirmed in 22 states. Here in Maryland, we have seen four individual cases of measles. Measles is considered to be highly infectious and reminds us all of the importance of practicing the three I’s: Identify, Isolate and Inform.
- IDENTIFY: Be vigilant for patients who present with signs and symptoms of measles and those with recent exposure to a known measles case or to communities where measles has been confirmed. With measles cases being reported locally as well as in other states and internationally, it is important to ask travel screening questions.
- Symptoms of measles include: fever, cough, runny nose, and red, watery eyes. Three to five days after symptoms begin, a rash breaks out. The measles rash is a maculopapular rash that begins around the face and upper neck and then gradually proceeds toward the hands and feet. A unique feature of the clinical presentation of measles is Koplik spots, a rash that appears as blue-white spots inside the cheeks and on the floor of the mouth.
- NOTE: If patients call with concerns about measles and ask to be evaluated, please contact your infection control representative to discuss how to safely evaluate the patient without exposing others. The goal is to prevent exposures by identifying these patients early.
- ISOLATE: If you suspect a patient has measles, immediately place a mask on the patient and implement airborne precautions as soon as possible. Do not allow the patient to sit in or walk through waiting rooms or other public areas unmasked. Immediately move the patient to a negative pressure room or a private room with a high efficiency particulate air (HEPA) filter, and place them on airborne precautions. If your area does not have a negative pressure room or available HEPA filter, the patient should be placed in a private patient room and wear a mask.
- INFORM: Immediately contact your infection control representative to discuss next steps.