06/05/2025
Action Requested
- Be aware there have been a total of 6 confirmed cases in Washington in 2 counties (King and Snohomish). There have been zero outbreaks in Washington this year.
- Be aware that as of May 29, 2025, a total of 1,088 confirmed measles cases were reported by 33 jurisdictions.
- There have been 14 outbreaks reported in 2025, and 90% of confirmed cases (977 of 1,088) are outbreak-associated. For comparison, 16 outbreaks were reported during 2024 and 69% of cases (198 of 285) were outbreak-associated.
- Isolate
- Have a planned triage process for patients with fever and rash so these patients are not waiting in common areas with other people.
- Patients with rash and fever should not stay in waiting rooms or other common areas.
- Immediately isolate patients with suspected measles in an airborne infection isolation room (AIIR) or a private room with a closed door.
- Follow standard and airborne precautions when evaluating suspected cases, regardless of vaccination status.
- After patient is discharged, do not use or have staff enter the room for 2 hours.
- Notify
- Report suspected measles cases to the Yakima Health District at (509) 249-6541 immediately AND before discharging or transferring patients.
- Test
- Collect the following specimens on patients with suspected measles:
- Nasopharyngeal swab placed in viral transport media; AND
- Urine, minimum 20mL, in sterile leak proof container; AND
- Serum, minimum 1mL, in red top or red-grey top tube
- Be aware, commercial testing cannot differentiate between wild-type measles and the vaccine strain in individuals who were vaccinated within the past 45 days. If measles is highly suspected and the patient was vaccinated within the last 45 days, testing should be conducted through the public health lab with prior approval from the Yakima Health District (YHD).
- Collect the following specimens on patients with suspected measles:
- Vaccinate
- Assess immunization status during healthcare visits at every visit and strongly recommend measles, mumps and rubella (MMR) vaccination based on the recommended schedule, health condition, occupation, and other risk factors such as travel.
- Under-vaccinated individuals may be at risk for measles infection due to outbreaks that occur in the US or anywhere else in the world.
Background
Measles illness starts with a prodrome of fever, cough, coryza, and conjunctivitis (typically lasting 2-4 days) and then a generalized maculopapular rash that typically begins on the face/head then spreads to the neck, trunk and extremities. Increases in measles cases and outbreaks are occurring in every region of the world.
CDC recommends all U.S. residents aged 6 months and older without evidence of immunity, who plan to travel internationally, get the MMR vaccine at least 2 weeks prior to departure. Infants 6 to 11 months of age who get the MMR vaccine before international travel should get an additional 2 doses of MMR according to the recommended schedule, after 1 year of age.
Report immediately
If you suspect measles or for any other questions about measles, please contact the Yakima Health District at (509) 249-6541.
Immediately isolate patients with suspected measles. Prevent exposure to other patients.
- Tell reception, phone and triage staff to identify patients with symptoms of possible measles.
- Tell the patient to enter through a back door wearing a mask. Or see the patient outside away from others.
- Immediately room the patient and close the door. Do not use the room until 2 hours after the patient leaves.
- Ensure all staff who will contact the patient have documented immunity to measles.
Resources for providers
- Suspect Measles Evaluation Worksheet
- CDC measles information for healthcare providers.
- Measles Case Definition.
- Immunizations for Schools.
- MMR Vaccine Exemption Law Change.
- Vaccine recommendations, CDC.
- Vaccinating pregnant people, CDC.
- Vaccine safety resources, CDC
