Download IDPH memo with flier - Centegra Health System

MEMORANDUM
TO:
Local Health Departments, Regional Offices of Illinois Department of Public
Health, Hospital Emergency Departments, Infection Control Preventionists and
Infectious Disease Physicians, Hospital Laboratories
FROM:
Communicable Disease Control Section
DATE:
July 12, 2013
SUBJECT:
Measles cases in Illinois/ Reporting of suspect cases
The Illinois Department of Public Health, along with the Centers for Disease Control and
Prevention and local health departments, have been investigating a confirmed and suspect case of
measles in persons who traveled together to Poland and returned to Illinois in late June. The
investigations are still ongoing, but it appears both cases are imported. Measles cases are rare in
Illinois but do occur. Since 2009, only three other cases have been reported and all had onset in
2011.
Measles Disease
Measles is a highly contagious viral illness that is characterized by a rash, fever, cold symptoms,
conjunctivitis, malaise, and Koplik’s spots (tiny white spots with bluish-white center inside the
mouth).
While measles is almost eradicated in the United States due to high vaccination coverage levels,
it still kills nearly 200,000 people each year around the world. Currently the virus is endemic in
many African, Asian, and European countries. Measles should be considered as a diagnosis in
unvaccinated persons presenting with a febrile rash illness as described above and recent
international travel or contact with travelers or other persons with rash illness.
Measles cases can develop complications, including encephalitis, pneumonia, ear infections
(permanent loss of hearing can result) or diarrhea. These complications are more common among
children under five years of age and adults over 20 years old. Measles infection can be fatal and
can cause miscarriage, premature birth or a low-birth-weight baby in pregnant women.
Reporting of Suspicious Cases
Physicians and other providers should contact their local health department to report a suspected
measles case as soon as possible but within 24 hours. In highly suspicious cases, health care
providers should not wait for laboratory results before contacting their local health department.
Laboratories should also report to their local health department positive lab tests for measles
within 24 hours. In turn, local health departments should report cases to the IDPH CD Section
within the same time period.
Prompt recognition, reporting and investigation of measles cases are important since
transmission can be limited with early case identification and vaccination of susceptible contacts.
For cases that have recently traveled, obtaining travel details (e.g. flight dates, times and
numbers) are important for identifying contacts among fellow travelers. Persons traveling
abroad should inquire about vaccinations before traveling abroad to prevent measles illness.
Resources
The following resources on measles infections are available:
 IDPH Measles flier - attached
 IDPH Measles Health Beat –
http://www.idph.state.il.us/public/hb/hbmeasles.htm
 IDPH Measles Summary for Health Care Providers –
http://www.idph.state.il.us/health/infect/reportdis/measles_provider-info.htm
 Image of Koplik’s spots –
http://phil.cdc.gov/phil/details.asp?pid=3187
If you have any questions regarding any of the above information, please contact the IDPH
Communicable Disease Control Section at 217-782-2016.
Measles Health Alert
2013
Recent measles outbreaks have originated from returning international
travelers. Measles is highly contagious. Please protect patients, visitors,
and staff!
Keep an eye out for measles symptoms:
Suspect measles
in patients with:
• fever and rash
• history of international
travel in the past 3
weeks or contact with
international visitors
Note: A history of 2 doses of
MMR vaccine does not
exclude a measles diagnosis.
Prodrome
· Mild to moderate fever
· Cough
· Coryza
· Conjunctivitis
Rash onset
· Fever spikes, often as high as
104º to 105º F
· Red, maculopapular rash that may
become confluent—typically starts
at hairline, then face, and spreads
rapidly down body
· Koplik's spots (tiny blue/white spots
on the bright red background of the
buccal mucosa) may be present
Act immediately if you suspect measles:
• Implement airborne infection control
precautions immediately, mask and
isolate patient—negative pressure
room, if available.
• Permit only staff immune to measles
to be near the patient.
• Notify local health department
immediately
• Expedite measles serologic (IgM
and IgG) and PCR testing at
IDPH lab; use of commercial
labs may delay definitive
diagnosis.
• Safeguard other facilities:
assure airborne infection
control precautions before
referring patients.
• Do not use any regular exam
room for at least 2 hours after a
suspected measles patient has
left the room.
Visit www.GetImmunizedCA.org for more information