FREE WEBINAR

Thursday, April 11, 12 -1 PM CT - Measles: Current Updates for a Renewed Threat

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As of April 4, 2024, a total of 113 measles cases were reported by 18 jurisdictions: Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York City, New York State, Ohio, Pennsylvania, Virginia, and Washington.

The CDC is tracking the outbreaks and updates their information weekly.

This virus represents a challenge to emergency medicine because it is very highly infectious and has rarely been seen in emergency departments in the recent past.

Please see the ACEP fact sheet about this disease for a review of its presentation, clinical course and implications for your emergency department

• Measles, one of the most contagious infectious diseases (infecting up to 90% of susceptible people who are exposed), is showing up in the United States, primarily in the unvaccinated and immunosuppressed.
• If there is a case in the emergency department, it is likely that everyone in that area has been exposed.
• High fever, conjunctivitis, cough and coryza (runny nose) often precede the characteristic rash. Koplik spots (a pathognomonic enanthem in the oral cavity) may or may not be visible.
• Patients who present with possible measles should have a PCR test performed, and if immunosuppressed, they may be a candidate for immunoglobulin.
• Though not common, patients may develop pneumonia or encephalitis, and deaths have been reported. Years later, a few patients may develop Subacute Sclerosing Panencephalitis (SSPE).

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More Information

• Measles: Cough, Coryza, Conjunctivitis...Crud! ACEP Pediatric EM Committee chair Christopher S. Amato, MD, FACEP, FAAP, discusses measles, emphasizing its symptoms, vaccination schedules, and outbreak data.
• Blutinger E, Schmitz G, Kang C, Comp G, Wagner E, Finnell JT, Cozzi N, Haddock A. Measles: Contemporary considerations for the emergency physician. J Am Coll Emerg Physicians Open. 2023 Sep 9;4(5):e13032. (Publication include rash presentation on various skin tones) 
• The Doc is in with Dr. Ryan Stanton - "The Measles" (March 7, 2024 - YouTube) 
• CDC information and resources:
• Increase in Global and Domestic Measles Cases and Outbreaks: Ensure Children in the United States and Those Traveling Internationally 6 Months and Older are Current on MMR Vaccination (CDC HAN - March 18, 2024)
• Measles Information For Healthcare Professionals – Diagnosing and Treating Measles
• Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings
• Recommendations on immunization of HCP for measles are maintained by CDC and Advisory Committee on Immunization Practices (ACIP)
• Measles Diagnosis At A Glance
• We Must Maintain Measles Elimination in the United States: Measles Clinical Presentation, Diagnosis, and Prevention (COCA call) - August 2023
• Koenig KL, Alassaf W, Burns MJ. Identify-isolate-inform: a tool for initial detection and management of measles patients in the emergency department. West J Emerg Med. 2015 Mar;16(2):212-9. 
• American Academy of Pediatrics:
• Measles: What Parents Need to Know
• Red Book Online Outbreaks: Measles