CDC issues interim guidance on measles infection control and prevention in health care

New government guidance covers what is acceptable evidence of immunity to measles and how to respond if health care personnel are exposed to the disease.

A recent interim guidance document from the CDC offered recommendations on the fundamental elements to prevent the spread of measles in health care settings.

The seven recommendations, which were published on the CDC's website, urge health care facilities to take a multifaceted approach to measles infection prevention and control, including the following measures.

  • Ensure that all health care personnel have presumptive evidence of immunity. Evidence consists of documentation of two-dose vaccination, laboratory evidence of immunity or disease, or birth before 1957. For personnel in the third category, vaccination should be considered generally, and it is recommended in the case of outbreak.
  • Adhere to standard and airborne precautions. Health care personnel without presumptive evidence of measles immunity should not enter a known or suspected measles patient's room if personnel with evidence of immunity are available. Regardless of immunity, they should use some form of respiratory protection at least as strong as an N95 filtering facepiece respirator.
  • Manage measles exposures. Recommendations for exposed health care personnel depend on whether they have evidence of immunity—if yes, they do not need postexposure prophylaxis or work restrictions; if no, they should receive prophylaxis and be excluded from work from the fifth to the 21st day after exposure.
  • Train and educate health care personnel. Training on transmission prevention should be job- or task-specific. Health care personnel should also be trained to use respiratory protection devices and personal protective equipment.
  • Establish reporting within hospitals and to public health authorities. There should be mechanisms and policies to promptly alert key facility staff, including hospital leadership, infection control, healthcare epidemiology, occupational health, clinical laboratory, and frontline staff, about patients with suspected or known measles. Someone should be designated to communicate with personnel and with public health authorities.

The guidance also includes appendices, one on respirators and one on evaluation of patients, visitors, and health care personnel who may have been exposed to measles in a health care setting.