Measles (rubeola) is highly contagious; one person infected with measles can infect 9 out of 10 unvaccinated individuals with whom they come in close contact.

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform clinicians and public health officials of an increase in global and U.S. measles cases and to provide guidance on measles prevention for all international travelers aged ≥6 months and all children aged ≥12 months who do not plan to travel internationally.

Schools, early childhood education providers, and healthcare providers should work to ensure students are current with MMR vaccine. 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.

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.

When considering measles:

  • Isolate: 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. 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.
  • Notify: Immediately notify the NC Epidemiologist on Call at 919-733-3419 as soon as measles is suspected. The state measles subject matter experts will assist with identifying the best testing pathway and with determining appropriate control measures.

For more information, see the CDC HAN Health Advisory on increased global incidence of measles and vaccination guidance here.