Interim Measles Infection Prevention Recommendations in Healthcare Settings | CDC

Interim Measles Infection Prevention Recommendations in Healthcare Settings | CDC

Fundamental Elements to Prevent Measles Transmission

Measles is most commonly acquired from persons in the household or community, but spread of measles can also occur in healthcare settings.[1]

Footnote 1

During 2001-2014, 6% of non-imported measles cases in the United States resulted from transmission in healthcare facilities. Fiebelkorn AP, Redd SB, Kuhar DT. Measles in Healthcare Facilities in the United States During the Postelimination Era, 2001-2014.external icon Clin Infect Dis. 2015 Aug 15;61(4):615-8.

While the most important measure to prevent measles transmission in all settings is ensuring community immunization, core measles prevention in healthcare settings requires a multi-faceted approach including:

• Ensuring HCP have presumptive evidence of immunity to measles (see Recommendations section)
• Rapidly identifying and isolating patients with known or suspected measles
• Adhering to Standard and Airborne Precautions for patients with known or suspected measles
• Routinely promoting and facilitating respiratory hygiene and cough etiquette
• Appropriately managing exposed and ill HCP

This interim guidance should be implemented in the context of a comprehensive infection prevention program to prevent transmission of all infectious agents among patients, HCP, and visitors.

Definition of healthcare personnel (HCP): “HCP” includes all paid and unpaid persons working in healthcare settings who have the potential for exposure to patients and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air. HCP include but are not limited to, emergency medical service personnel, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the healthcare setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel).

Definition of healthcare settings: “Healthcare settings” refers to places where healthcare is delivered and includes, but is not limited to, acute care facilities, long-term acute care facilities, inpatient rehabilitation facilities, nursing homes and assisted living facilities, home healthcare, vehicles where healthcare is delivered (e.g., mobile clinics), and outpatient facilities, such as dialysis centers, physician offices, and others.

Definition of exposure to measles for HCP in healthcare settings: HCP exposures to measles in a healthcare setting include spending any time while unprotected (i.e., not wearing recommended respiratory protection):

• In a shared air space with an infectious measles patient at the same time, or
• In a shared air space vacated by an infectious measles patient within the prior 2 hours* See Appendix A.

* Measles has been reported to survive in air for up to 2 hours. For spaces with a defined rate of air changes per hour (ACH), see the following for additional considerations about estimating the time for 99.9% removal efficiency of airborne contaminants: Table B1 “Air changes/hour (ACH) and time required for airborne-contaminant removal by efficiency” from the 2003 Guidelines for Environmental Infection Control in Health-Care Facilities.