Measles

Measles is a highly contagious infection caused by the measles virus. Symptoms include high fever, a rash and red eyes (conjunctivitis). It can be particularly serious in infants and people with weakened immune systems.

Usually via droplet infection from the patient's nose and throat. Other routes of transmission:

• Direct contact.
• Indirect contact (hands, doorknobs).
• Spread through the air by droplet nuclei.

4 days before to 4 days after the onset of the rash.

The incubation period from exposure to the onset of the prodromal phase is 7 to 14 days (average 10 days). The incubation period from exposure to the onset of the exanthema is 7 to 18 days (average 14 days).

Employees in direct patient care are actively offered vaccination if they are not or insufficiently protected. Upon employment, you will be screened to determine whether you have been vaccinated or have had measles. If you are unsure whether you have been vaccinated through the National Immunization Program (since 1978), request your vaccination records at Rijksvaccinatieprogramma. Not sure whether you have had measles? Then take the initiative to have an antibody titer test done by the occupational health and safety service. That way, you can be sure that you are well protected.

Measles is highly contagious. There is a risk of infection if you have been in the same room as an infectious source without adequate protection, even up to 2 hours after the source has left.

Individuals who are not (fully) vaccinated or have no history of measles infection.

• Unvaccinated young children.
• Older people.
• People with underlying chronic conditions.
• People with weakened immune systems.
• Pregnant women.

The risk of further spread is very high and must be limited as much as possible in all departments.

Depending on the isolation policy of your umc; FFP2 mask, goggles, gloves, isolation gown, see also SRI guideline Isolation.

In case of a real risk of infection among employees who are not or insufficiently protected, follow-up action is required. Insufficiently protected means: not or insufficiently vaccinated or not having had measles. Consider an emergency antibody test if there is any doubt about the degree of protection.

If there are no protective antibodies: prohibit work in the hospital during days 3-18 after last exposure to prevent further spread. If possible, administer a MMR vaccination as soon as possible after contact.

Consider administering immunoglobulin to employees who are at risk of severe disease. This should be done in consultation with the treating physician.

• Measles | LCI guideline RIVM
• Protection against measles in healthcare | LCI guideline RIVM
• SRI guideline Isolation