Measles: Summary for Health Care Providers
Typically starts three to four days (range one to eight days) before rash onset. Fever typically reaches 101F by day of rash onset.
Distribution and progression—starts at hairline ( behind ears) and extends to face and neck on day one, spreads to trunk on day two, and extremities on day three. Usually spares palms and soles. Starts to fade on face on day four, then fades on trunk and extremities. Usually lasts four to seven days.
Character-- maculopapular, erythematous, blanching; becomes confluent in blotches especially in areas where the rash develops first. Palms and soles rarely involved. Bright red, often raised, and “velvety” to touch on days one and two. Begins to fade on days three and four, may turn brownish, followed by fine desquamation.
Minimal clinical criteria: the vast majority of cases are classical and meet the minimum clinical criteria
Differential diagnosis: includes but not limited to rubella, fifth disease (parvovirus B19), HHV-6 infection, toxic shock, enterovirus or adenovirus infection, mononucleosis, scarlet fever, roseola, Kawasaki’s disease, RMSF, and drug reaction.
About 10 days, but may be seven to18 days from exposure to onset of fever, usually about 14 days until rash appears.
PERIOD OF COMMUNICABILITY
From one day before beginning of the prodromal period (usually about four days before onset) to four days after rash appearance.
Laboratory testing for measles is available through the Illinois Department of Public Health laboratory and Centers for Disease Control and Prevention. The Department can perform PCR testing. The lab can also submit specimens for a highly sensitive and specific IgM testing to be performed by the CDC.
Anti-measles IgM may be undetectable on the day the rash appears; repeat testing may be indicated.
False positive and negative results have been reported with IgM tests.
See attached for information about specimen collection.
In addition to infection control procedures, prevention of the spread of measles depends on prompt immunization of people at risk of exposure or people already exposed who cannot readily provide documentation of measles immunity.
of Public Health
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Springfield, Illinois 62761
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