Measles (Rubeola) Resources for Health Care Providers

• Consider a screening process for your facility to identify patients with signs and symptoms of measles prior to arrival.
  • Consider evaluating a patient with signs or symptoms of measles outside the clinic (e.g., in their car, outdoors) if the patient’s condition is suitable. 
  • For people with signs or symptoms of measles, provide instructions for arrival, including:
    Which entrance to use
    How to let staff know they have arrived
    To wear a facemask in the facility (if possible)
• Post signs/posters in appropriate languages listing the signs and symptoms of measles and instruct individuals on what to do if they experience symptoms.
• Post signs/posters in appropriate languages about respiratory hygiene, cough etiquette, and hand hygiene at the facility entrance and in common areas (such as waiting areas, elevators, cafeterias).
• Provide hygiene supplies such as hand hygiene products, facemasks, tissues, etc.
• Instruct emergency services to notify the receiving facility/accepting physician in advance when transporting a patient with known or suspected measles.

When the patient arrives, the patient should be taken immediately to an airborne infection isolation room (AIIR), if available. If an AIIR is not available, place the patient in a private room that minimizes shared air space with other areas. Keep the door closed, have the patient wear a mask (if possible) and transfer the patient as soon as possible to a facility where an AIIR is available.

When transporting the patient through the facility, avoid busy hallways and large common spaces. Keep in mind that even a short time in shared air space could lead to possible exposures, and that anyone in that airspace when the patient passes through and in the next two hours, may be considered exposed. For more information, see "What is an exposure?"

Recommended respiratory protection is a respirator that is at least as protective as a fit-tested, NIOSH-certified, disposable N95 filtering facepiece respirator.

Those wearing surgical/procedural masks, KN95, etc. are not considered protected against measles.

In health care settings, people potentially exposed to measles include patients, visitors, and health care personnel who are not wearing recommended respiratory protection* (regardless of presumptive evidence of measles immunity status) who are:

• 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 (or the period of time aligning with the CDC ACH Table).

This exposure definition includes any period of time in the space for either the infectious patient or the exposed people. While a mask minimizes the potential of transmission, a mask does not eliminate possible exposure.

Be prepared to do contact tracing, notify and administer post-exposure prophylaxis (PEP) if appropriate to anyone in your facility who is considered exposed.

For more information on health care exposure investigations, see Measles Contact Investigations in Hospitals and Health Care Systems (PDF).

For more information on PEP, see Measles Post-Exposure Prophylaxis (PEP) for Non-Symptomatic Susceptible Contacts (PDF).

*Recommended respiratory protection is a respirator that is at least as protective as a fit-tested, NIOSH-certified, disposable N95 filtering facepiece respirator.

**Different areas in larger spaces or rooms that share a common air handling system, such as a large emergency department with patient waiting, triage, HCP work areas, or multiple individual patient rooms that share a common unfiltered air source, are also shared airspaces.

After the patient leaves the space, the space should remain vacant up to 2 hours to allow for 99.9% of airborne-contaminant removal. For spaces with known rate of air changes per hour (ACH), this time may be decreased as directed by the CDC ACH Table.

Personnel responsible for maintaining the building's air handling system(s) should be consulted when assessing exposure risk between different rooms or areas of a facility, e.g., to identify where ventilation return air is recirculated (without passing through HEPA filtration). Different areas in larger spaces or rooms that share a common air handling system, such as a large emergency department with patient waiting, triage, HCP work areas, or multiple individual patient rooms that share a common unfiltered air source, are also shared airspaces.

Personnel who enter the room before the appropriate time for airborne-contaminant removal has passed should wear respiratory protection (i.e., a respirator) that is at least as protective as a fit-tested, NIOSH-certified disposable N95 filtering facepiece respirator.

Standard cleaning and disinfection procedures are adequate for measles virus environmental control in health care settings. Use an EPA-registered disinfectant, per manufacturer's instructions.

Personnel responsible for maintaining the building's air handling system(s) should be consulted when assessing exposure risk based on a facility’s air handling. When in doubt, reach out to device manufacturer to confirm function based on the specific model and installation.