Confirmed Measles Case Traveled to New Hampshire, July 2017

July 18, 2017

Key Points and Recommendations:

  • Healthcare providers should be aware that a person with confirmed measles traveled to Hampton Beach, New Hampshire (NH) on 7/9/17, and purchased food at 4 beachside establishments during a time when s/he was considered to be infectious.

  • Healthcare providers should test for measles in persons presenting with a consistent clinical syndrome of fever, cough, conjunctivitis, and coryza (the three "C's"), followed by development of a maculopapular rash.

  • Healthcare providers should ensure their patients are appropriately vaccinated for measles.

  • Suspect measles cases should be managed under airborne infection isolation and immediately reported to the NH Division of Public Health Services (DPHS) at 603-271-4496 (after hours, 603-271-5300).

  • To test for measles, the following specimens should be obtained and submitted to NH Public Health Laboratories:

    • Oropharyngeal, nasopharyngeal, or nasal swab for polymerase chain reaction (PCR)

    • Serum for IgM serology

Situation:

The NH DPHS has been notified of a confirmed measles case from another state who spent about 6 hours at Hampton Beach in New Hampshire, on the afternoon of July 9th while s/he was considered infectious. This patient spent almost all time in open air, including visits to four casual eating establishments. The incubation period after exposure to measles is typically 10-14 days but can be as long as 21 days; therefore any secondary cases arising from exposure to this source case are likely to present between now and July 30. There is no role for post-exposure prophylaxis with vaccine or immunoglobulin, but those who are not vaccinated should be encouraged to get vaccinated to prevent future infection.

Presumptive Evidence of Measles Immunity:

Persons can be presumed to have immunity to measles if any of the following criteria apply:

  1. Documentation of age-appropriate vaccination for measles,*

  2. Laboratory evidence of measles immunity or evidence of past disease, or

  3. Birth before 1957 (note: this criteria does not apply to healthcare workers).

*Appropriate vaccination status differs by age and risk of exposure or transmission. Pre-school aged children and adults not at high risk only need one dose of the MMR vaccine. School-aged children in grades K-12, students at post-secondary educational institutions, healthcare personnel, and international travelers should have 2 doses of measles vaccine, separated by at least 28 days.

Background Information:

See the most recent ACIP MMR vaccine recommendations for further details.

For any questions regarding the contents of this message, please contact NH DHHS, DPHS, Bureau of Infectious Disease Control at 603-271-4496 (after hours, 603-271-5300).

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