Measles
Measles Playbook
To help infection preventionists quickly activate measles prevention efforts, APIC’s Emerging Infectious Diseases Task Force has created a Measles Playbook that IPs can download and customize for use in their facilities. The playbook is a concise workflow document that is designed to be user-friendly and operational for busy IPs. In the playbook, you will learn about signs, symptoms, risks, effective infection prevention measures, and avoiding staff exposure. Access the playbook here.
About Measles
- The measles virus, a member of the Paramyxoviridae Family, causes measles
- Measles is one of the most contagious infectious diseases known, and the most contagious vaccine-preventable disease
- Primary Mode: Respiratory droplets and airborne spread via coughing, sneezing, or breathing
- Environmental persistence: The Virus can remain airborne or on surfaces for up to two hours
- Approximately 90% of susceptible individuals who are exposed will become infected
- Incubation Period: 7 to 14 days
- Early symptoms of measles infection can be similar to those of many respiratory viral illnesses
- Characteristic Sign: Koplik spots (tiny white lesions inside the mouth)
- Before widespread vaccination, Measles infected 3 to 4 million people annually in the United States
- Declared eliminated in the United States in 2000, but a resurgence has occurred due to declining vaccination coverage and increased travel
- The COVID-19 pandemic disrupted routine vaccinations worldwide, leading to millions of missed Measles, Mumps, and Rubella (MMR) doses and increased outbreak risk
- Vaccination is the most effective protection against measles.
- Increasing vaccine hesitancy and vaccine exemptions have contributed to the increase in measles outbreaks in the US.
Current Situation
- As of April 2025: Nearly 900 cases of measles and three measles-related deaths have been reported across 29 U.S. states, with most cases in Texas, New Mexico, Oklahoma, Kansas, Ohio, and Pennsylvania
- Over 90% of cases are linked to outbreaks, rather than isolated travel-associated infections
- Global surges are occurring in Yemen, India, Pakistan, and Ethiopia
- Click here for the most recent case counts in the United States (CDC)
- Click here for the Global case count (WHO)
Measles is a highly contagious, vaccine-preventable disease that healthcare facilities must be prepared to manage. Infection preventionists across acute care, outpatient/ambulatory, and long-term care settings should:
- Implement “front-door” screening for rash illness with fever, travel/exposure history, and vaccine status
- Immediately mask and isolate the suspected measles patient under Airborne Precautions (AIIR/negative pressure preferred)
- Verify staff immunity (documentation of MMR vaccination or lab-confirmed immunity)
- Ensure clear communication plans with Occupational/Employee Health and local/state public health departments
- Educate staff and patients about the importance of vaccination and post-exposure prophylaxis when appropriate
- Remind employees who plan to travel internationally to review their vaccination status, including the MMR vaccine, before departure
APIC Resources and Tools
Click here to download the APIC Measles Playbook
- Developed by the APIC Emerging Infectious Diseases Task Force to help infection preventionists rapidly activate Measles prevention efforts
- The playbook is a concise workflow document that is designed to be user-friendly and operational for busy IPs.
Click Here to Watch what IPs need to know about Measles
Click Here to Watch What the General Public needs to know about Measles
- APIC’s Rapid Rundown video provides concise, high-yield summaries tailored for busy infection preventionists in under 3 minutes
Click Here to access the APIC Text – Chapter 85: Measles, Mumps, and Rubella
- Chapter 85 of the APIC Text provides comprehensive guidance for an infection preventionist on Measles, Mumps, and Rubella
