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Measles Outbreak

Thursday, April 18, 2019  
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Dear Providers:

As you may know, there have been multiple outbreaks of measles in the U.S. So far this year there have been 465 cases in 19 states. This is the second-greatest number of cases reported in the U.S. since measles was eliminated in 2000.  The majority of measles cases are in New York City and New York state, which are primarily among unvaccinated people in Orthodox Jewish communities and associated with travelers who brought measles back from Israel.  

With the upcoming Passover holiday, which begins the evening of Friday April 19 and ends the evening of Saturday, April 27, we anticipate there may be more opportunities for measles to spread. 

Please be aware that many people celebrating Passover do not stay at home. Families may travel to resorts, hotels, or take cruises for the holiday.  And there will likely be an influx of international travelers before Passover, including many from Israel where measles is circulating. Popular destinations include New York, New Jersey, Florida, Las Vegas, Arizona, and Washington, D.C.

Measles is highly contagious and spreads through the air when an infected person coughs or sneezes.  Healthcare professionals should be vigilant about measles—

  • Ensure all patients are up to date on MMR vaccine.
  • Consider measles in patients presenting with febrile rash illness and clinically compatible measles symptoms (cough, runny nose, and conjunctivitis). Patients exposed to measles while traveling for Passover could begin to develop symptoms between late April through mid-May.
  • Ask patients about recent travel internationally or to domestic venues frequented by international travelers, as well as a history of measles exposures in their communities.
  • Promptly isolate patients with suspected measles to avoid disease spread and immediately report the suspect measles case to the health department.
  • Obtain specimens for testing from patients with suspected measles, including viral specimens for genotyping, which can help determine the source of the virus. Contact the local health department with questions about submitting specimens for testing.

Measles is so contagious that if one person has it, up to 9 of 10 people around them will also become infected if they are not protected. The virus can cause serious health complications, such as pneumonia or encephalitis, and even death.

CDC continues to encourage parents to get their children vaccinated on schedule with the MMR vaccine. People 6 months and older should be protected with the vaccine before leaving on international trips. 

We appreciate your help spreading this message. Please share this letter as needed among your public health and community organizations. For additional information and resources on measles please visit the CDC’s measles website (https://www.cdc.gov/measles/index.html).

Thank you,

Melinda Wharton, MD, MPH

Director, Immunization Services Division
National Center for Immunization & Respiratory Diseases
Centers for Disease Control and Prevention

The NPA| The Nurse Practitioner Association New York State

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