State public health officials announce first confirmed measles case in Massachusetts since 2020
Case is linked to international travel
July 18, 2024
BOSTON — The Massachusetts Department of Public Health (DPH) has confirmed that an adult resident from Worcester County who recently traveled internationally was diagnosed with measles in early July 2024. This is the first confirmed case of measles in a Massachusetts resident since early 2020.
People who may have been exposed to measles from this case have already been contacted and provided appropriate public health recommendations.
“Measles is a highly contagious, airborne disease, which has increased worldwide, including here in the United States and in neighboring states in New England,” said Public Health Commissioner Robbie Goldstein, MD, PhD. “Cases of measles have been reported in 30 states since the beginning of last year, mostly in people and communities who are unvaccinated. Vaccination is the best way to protect against measles.”
According to the US Centers for Disease Control and Prevention, as of July 11, a total of 167 measles cases have been reported in 24 jurisdictions across the United States in 2024. The majority were unvaccinated or had unknown vaccination status (84 percent), 11 percent had one dose of the Measles, Mumps, and Rubella (MMR) vaccine, and 5 percent had two doses. Nearly half of all reported cases (46 percent) were under 5 years of age. Among reported cases, 53 percent were hospitalized.
Currently, large measles outbreaks are occurring in Europe and elsewhere internationally. Many of the cases reported in the United States are associated with recent travel. Last month, DPH alerted residents about a potential exposure to measles tied to an international visitor who traveled through Boston to Amsterdam while infectious.
DPH urges anyone who does not know their measles immunization status to contact their healthcare provider to get vaccinated with at least one dose of the MMR vaccine. Health care providers who suspect measles should call DPH at 617-983-6800 immediately for recommendations and testing guidance. Providers in Boston should call the Boston Public Health Commission at 617-534-5611.
Increase in Measles Cases and Outbreaks: Ensure Children in Massachusetts and Those
Traveling Internationally 6 Months and Older are Current on MMR Vaccination
On March 18, 2024, CDC issued a Health Alert Network (HAN) Health Advisory to alert health providers to the global and domestic increase in measles cases and to provide recommendations about how to reduce the occurrence of new measles cases and outbreaks in the US.
Full Health Alert Network Advisory: Here
Recommendations for Healthcare Providers
- Schools, early childhood education providers, and healthcare providers should work to ensure students are current with MMR vaccine
https://www.cdc.gov/vaccines/vpd/measles/index.html
- Children who are not traveling internationally should receive their first dose of MMR at age 12 to 15 months and their second dose at 4 to 6 years.
- All U.S. residents older than age 6 months without evidence of immunity who are planning to travel internationally should receive MMR vaccine prior to departure.
- Infants aged 6 through 11 months should receive one dose of MMR vaccine before departure. Infants who receive a dose of MMR vaccine before their first birthday should receive two more doses of MMR vaccine, the first of which should be administered when the child is age 12 through 15 months and the second at least 28 days later.
- Children aged 12 months or older should receive two doses of MMR vaccine, separated by at least 28 days.
- Teenagers and adults without evidence of measles immunity should receive two doses of MMR vaccine separated by at least 28 days.
- At least one of the following is considered evidence of measles immunity for international travelers: 1) birth before 1957, 2) documented administration of two doses of live measles virus vaccine (MMR, MMRV, or other measles-containing vaccine), or 3) laboratory (serologic) proof of immunity or laboratory confirmation of disease.
- Consider measles as a diagnosis in anyone with fever (≥101°F or 38.3°C) and a generalized maculopapular rash with cough, coryza, or conjunctivitis who has recently been abroad, especially in countries with ongoing outbreaks. https://www.cdc.gov/globalhealth/measles/data/global-measles-outbreaks.html
When considering measles, then:
- Isolate: Do not allow patients with suspected measles to remain in the waiting room or other common areas of a healthcare facility; isolate patients with suspected measles immediately, ideally in a single-patient airborne infection isolation room (AIIR) if available, or in a private room with a closed door until an AIIR is available. Healthcare providers should be adequately protected against measles and should adhere to standard and airborne precautions when evaluating suspect cases, regardless of their vaccination status. Healthcare providers without evidence of immunity should be excluded from work from day 5 after the first exposure until day 21 following their last exposure. Offer testing outside of facilities to avoid transmission in healthcare settings. Call ahead to ensure immediate isolation for patients referred to hospitals for a higher level of care.
https://www.cdc.gov/vaccines/vpd/mmr/public/index.html
- Notify: Immediately notify state, tribal, local, or territorial health departments (24-hour Epi On Call contact list) about any suspected case of measles to ensure rapid testing and investigation. States report measles cases to CDC.
- Test: Follow CDC’s testing recommendations and collect either a nasopharyngeal swab, throat swab, and/or urine for reverse transcription polymerase chain reaction (RT-PCR) and a blood specimen for serology from all patients with clinical features compatible with measles. RT-PCR is available at many state public health laboratories, through the APHL Vaccine Preventable Disease Reference Centers, and at CDC. Given potential shortages in IgM test kits, providers should be vigilant in contacting their state or local health department for guidance on testing.
- Manage: In coordination with local or state health departments, provide appropriate measles post-exposure prophylaxis (PEP) as soon as possible after exposure to close contacts without evidence of immunity, either with MMR (within 72 hours) or immunoglobulin (within 6 days). The choice of PEP is based on elapsed time from exposure or medical contraindications to vaccination."
Recommendations for Parents and International Travelers
- Even if not traveling, ensure that children receive all recommended doses of MMR vaccine. Two doses of MMR vaccine provide better protection (97%) against measles than one dose (93%). Getting MMR vaccine is much safer than getting measles, mumps, or rubella.
- Anyone who is not protected against measles is at risk of getting infected when they travel internationally. Before international travel, check your destination and CDC’s Global Measles Travel Health Notice for more travel health advice, including where measles outbreaks have been reported.
- Parents traveling internationally with children should consult with their child’s healthcare provider to ensure that they are current with their MMR vaccinations at least 2 weeks before travel. Infants aged 6 to 11 months should have one documented dose and children aged 12 months and older should have two documented doses of MMR vaccine before international travel. Depending on where you are going and what activities you plan, other vaccines may be recommended too.
- After international travel, watch for signs and symptoms of measles for 3 weeks after returning to the United States. If you or your child gets sick with a rash and a high fever, call your healthcare provider. Tell them you traveled to another country and whether you or your child have received MMR vaccine.
PRESS RELEASE FROM THE VIRGINIA DEPARTMENT OF HEALTH
Release Date: January 13, 2024
"VIRGINIA HEALTH OFFICIALS INVESTIGATING POTENTIAL MEASLES EXPOSURES IN NORTHERN VIRGINIA
Virginia Department of Health is Working to Identify People Who Are at Risk
(Richmond, Va.) – The Virginia Department of Health (VDH) was notified of a confirmed case of measles in a person who traveled through Northern Virginia when returning from international travel. Out of an abundance of caution, VDH is informing people who were at various locations, including Dulles International Airport on January 3, 2024, and Ronald Reagan Washington National Airport on January 4, 2024, that they may have been exposed. Health officials are coordinating an effort to identify people who might have been exposed, including contacting potentially exposed passengers on specific flights.
Listed below are the dates, times, and locations of the potential exposure sites associated with this case of measles:
- Dulles International Airport (IAD): the international arrivals area of the main terminal between 4:00 p.m. and 8:00 p.m. on Wednesday, January 3, 2024
- Ronald Reagan Washington National Airport (DCA): Terminal A between 2:30 p.m. and 6:30 p.m. on Thursday, January 4, 2024
Measles is a highly contagious illness that can spread easily through the air when an infected person breathes, coughs, or sneezes. Measles symptoms usually appear in two stages. In the first stage, most people have a fever of greater than 101 degrees, runny nose, watery red eyes, and a cough. These symptoms usually start 7 to 14 days after being exposed. The second stage starts 3 to 5 days after symptoms start, when a rash begins to appear on the face and spread to the rest of the body. People with measles are contagious from 4 days before the rash appears through 4 days after the rash appeared.
What should you do if you were at one of the above locations on the day and time specified?
- If you have never received a measles containing vaccine (either the measles, mumps and rubella [MMR] vaccine or a measles only vaccine which is available in other countries), you may be at risk of developing measles. Anyone who was exposed and is at risk of developing measles should watch for symptoms until January 25, 2024. If you notice the symptoms of measles, immediately isolate yourself by staying home and away from others. Contact your healthcare provider right away. Call ahead before going to your healthcare provider’s office or the emergency room to notify them that you may have been exposed to measles and ask them to call the health department. This will help protect other patients and staff.
- If you have received two doses of a measles containing vaccine, or were born before 1957, you are protected and do not need to take any action.
- If you have an immunocompromising condition, please consult with your healthcare provider if you have questions or develop symptoms.
- If you have received only one dose of a measles containing vaccine, you are very likely to be protected and your risk of being infected with measles from any of these exposures is very low. However, to achieve complete immunity, contact your healthcare provider about getting a second vaccine dose.
Measles is preventable through a safe and effective MMR vaccine. Two doses of the vaccine are given to provide lifetime protection. Virginia has high measles vaccination rates, with approximately 95% of kindergarteners fully vaccinated against measles. However, infants younger than 12 months of age are too young to be vaccinated. These infants, and others who are not vaccinated, are very susceptible to infection if they are exposed to someone with measles. If you or your child have not yet been vaccinated, call your health provider. To check your immunization status, call your healthcare provider or request records from the VDH Immunization Record Request Form. For additional information, contact your local health department.
Healthcare providers should maintain an increased index of suspicion for measles in clinically compatible cases at all times, especially if patients were recently exposed. Measles is an immediately reportable disease. Contact the local health department right away to report any suspected cases and arrange for public health testing. For additional guidance on testing and infection control measures for healthcare providers, visit https://www.vdh.virginia.gov/measles/hcp/.
Residents with additional questions about their potential exposure can call VDH at (804) 864-8140 or email [email protected]. For more information about measles visit www.vdh.virginia.gov/measles/"
Original Press Release: VIRGINIA HEALTH OFFICIALS INVESTIGATING POTENTIAL MEASLES EXPOSURES IN NORTHERN VIRGINIA
For more information about Measles, please visit: https://www.mass.gov/info-details/measles