**FOR USE BY HEALTHCARE PROVIDERS ONLY** – NOT for Public Distribution/Posting as may contain potentially CONFIDENTIAL health information.
A case of measles was recently reported to the Houston Health Department (HHD). The case was a child between the ages of 1 – 3 years in Houston. This is the first case of measles seen in the City of Houston since 2013.
Persons in contact with the child between the days of August 14 and August 24, 2018 may be at risk of developing measles. Depending on the date of contact, symptoms may appear any time up to September 12, 2018.
Healthcare providers are requested to aid in this investigation by considering measles when evaluating febrile rash illnesses and by reporting suspected measles cases promptly to their local health department. By Texas statute, suspected measles is to be reported immediately.
This case has been in the news media recently. The patient visited hospital emergency rooms, a primary care provider, and hospital in-service — during a period in which the patient was contagious. The HHD is working closely with providers, clinics, and hospitals to ensure staff and clients are aware and take precaution. The best way to prevent measles is to be vaccinated with two doses of the MMR vaccine. Providers can refer any uninsured or underinsured patients to their local health department.
The clinical case definition for measles is an illness characterized by all of the following:
- Generalized maculopapular rash lasting 3 or more days
- Temperature greater than or equal to 101°F (38.3°C)
- Cough, coryza, or conjunctivitis
Measles cases may present with a nonspecific febrile illness before onset of the characteristic rash. The incubation period for measles is generally 14 days from exposure to rash; however, it can range from 7-18 days. Measles is highly communicable, with >90% secondary attack rate among susceptible persons. Measles may be transmitted from 4 days prior to 4 days after rash onset. Measles can occur in previously immunized individuals
It is imperative that measles cases be reported immediately. Healthcare providers must report cases to their local health department as soon as measles is suspected. Health departments will assist with appropriate shipment and testing of specimens.
The Texas Department of State Health Services laboratory in Austin can conduct measles testing:
- A blood specimen for serology and throat swab for viral culture or PCR should be collected at the first contact with a suspected measles case. Currently PCR testing is only available through public health laboratories. Local health departments can help to coordinate testing.
Again, you are asked to consider measles when evaluating febrile rash illnesses and to report any suspect measles cases to your local health department immediately.
| HOUSTON AREA HEALTH DEPARTMENTS | |||
| Harris County Public Health | Houston Health Department | ||
| Telephone: | (713) 439-6000 | Telephone: | (832) 393-5080 24 hr. # |
| Fax: | (713) 439-6306 | Fax: | (832) 393-5232 |
| After Hours: | (713) 755-5000 | www.houstontx.gov/health/index.html | |
| www.hcphes.org | |||
| Texas Department of State Health Services | Galveston County Health District | ||
| Health Service Region 6/5 South | Telephone: | (409) 938-2322 | |
| Telephone: | (713) 767-3000 | Fax: | (409) 938-2399 |
| Fax: | (713) 767-3006 | After hours: | (888) 241-0442 |
| After hours: | (800) 270-3128 | www.gchd.org | |
| www.dshs.state.tx.us/region6-5/default.shtm | |||
| Montgomery County Public Health Department | Fort Bend County Health and Human Services | ||
| Telephone: | (936) 523-5026 | Telephone: | (281) 342-6414 |
| Fax: | (936) 539-9272 | Fax: | (281) 342-7371 |
| After hours: | (888) 825-9754 | After hours: | (281) 434-6494 |
| www.mchd-tx.org/publichealth | www.fbchealth.org | ||
| Brazoria County Health Department | |||
| Telephone: | (979) 864-1166 | ||
| Fax: | (979) 864-3955 | ||
| After hours: | (800) 511-1632 | ||
| www.publichealthmatters.net | |||