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Measles guidance for healthcare providers

Short URL: kingcounty.gov/advisories/measles

Actions requested

Remain vigilant for possible cases of measles. 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, especially in a person who has recently traveled internationally, or domestically to a region with a known measles outbreak or has other known or suspected exposure to measles.

On January 20, 2026, the Washington State Department of Health (WA DOH) released their Interim Pediatric Measles Outbreak Vaccine Recommendations guidance for children who live in or visit WA counties with active measles outbreaks; this currently only applies to Snohomish County and may change based on local measles epidemiology.

MMR vaccination remains the most important tool for preventing measles infections and spread from imported cases. Two doses of MMR vaccine provide 97% protection against measles while one dose provides 93% protection.

  • 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 Public Health at 206-296-4774 immediately AND before discharging or transferring patients.
    • Public Health will ensure appropriate, rapid testing and investigation.

  • 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
    • Public Health will facilitate diagnostic testing with Washington State Public Health Laboratory (WAPHL).

  • Manage

    • Health care facilities should identify potentially exposed persons at the facility (patients, visitors, staff, and volunteers).
    • Public Health will identify close contacts and recommend post-exposure prophylaxis (PEP) for eligible people.

  • Vaccinate

    • Assess immunization status at every healthcare visit and ensure patients are aware of their status. at every healthcare visit.
    • Ensure all patients without evidence of immunity are up to date on MMR vaccine per WA DOH’s routine measles vaccine recommendations: including for international travelers (regardless of the destination) or domestic travelers to outbreak areas:
      • Children are routinely recommended to receive 2 doses of MMR, the first at 12–15 months of age and the second at 4–6 years of age before school entry.
      • Healthcare providers should not discourage families from getting an early
        second MMR or MMRV dose for their child as long as the minimum interval for the vaccine (28 days for MMR, 3 months for MMRV) has been met.
      • Adults who are not at high risk of exposure are recommended to have at least 1 documented dose of MMR in their lifetime, or other evidence of immunity (e.g., positive measles antibody (IgG)).
      • Adults who are at high exposure risk, including students at post-secondary institutions, healthcare workers, and international travelers, should receive 2 doses of MMR.
    • For any international travel or domestic travel to measles outbreak areas:
      • Infants 6-11 months of age: Receive an early dose of MMR at least 2 weeks prior to departure. Infants who get one dose of MMR before their first birthday should get two more doses according to the routinely recommended schedule.
      • Persons 12 months of age or older without presumptive evidence of immunity: Receive 2 doses of MMR or MMRV at least 2 weeks prior to travel. The second dose can be administered 28 days later if the first dose was MMR or 90 days later if the first dose was MMRV.

Resources

This page is also available in PDF format (254 KB)

For healthcare providers

For infection preventionists

For laboratories

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