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Measles cases reported in Arkansas

Measles reported in Arkansas

The Arkansas Department of Health (ADH) reported a second confirmed pediatric measles case in an unvaccinated Arkansas resident from Faulkner County on Thursday, April 10. The individual who tested positive was exposed during out of state travel.

Measles is a highly contagious illness that can cause severe health complications. Symptoms include fever, cough, runny nose, conjunctivitis, and rash. Patients are infectious for both four days before and after they develop a rash. The measles, mumps, and rubella (MMR) vaccine can provide long-lasting protection.

Measles has been eliminated (no sustained circulation) in the United States for decades. However, there can still be measles cases, as it is easily imported by unvaccinated travelers and can spread in under-immunized communities.

Disease course

The incubation period is typically 11–12 days from exposure to measles virus until the first symptoms appear (prodromal symptoms). A rash follows the prodromal symptoms 2–4 days later and usually lasts 5–6 days. Measles is infectious 4 days before and 4 days after rash onset.

Symptoms

• Prodromal: Fever, cough, coryza, or conjunctivitis. Koplik spots (tiny white spots inside the mouth) may also appear 2–3 days after symptoms first appear.
• Rash: A maculopapular rash (rash of both flat and raised skin lesions) begins on the head and face and then spreads downward to the neck, trunk, arms, legs, and feet. The spots may become joined together as they spread from the head to the body. Fever may spike to more than 104° F when rash appears.

Complications

• Most common complications: Diarrhea and otitis media, which is an infection or inflammation of the middle ear, often causing ear pain, fever, and potentially hearing loss.
• Most severe complications: Pneumonia, encephalitis, and death. Patients may require hospitalization. Children younger than 5, adults older than 20, pregnant women, and immunocompromised persons are at most risk of serious complications.

What to do if you have a suspected case

1. Immediately mask and isolate the patient in a room with a closed door (negative pressure room if available). Follow standard and airborne precautions.
2. Only allow health care workers with presumptive evidence of measles immunity* to attend the patient; they must use N-95 masks.
3. Evaluate the patient and order measles confirmatory testing (collect a throat or nasopharyngeal swab for RT-PCR and serum for IgM measles testing).
4. Contact infection control if available at your facility.
5. Immediately report this suspected case to your local and/or state health department.

For questions regarding specimen collection, storage, and shipment, please visit www.cdc.gov/measles/php/laboratories/?CDC_AAref_Val=https://www.cdc.gov/measles/lab-tools/rt-pcr.html

Resources

• Measles information for healthcare providers
• Measles vaccine recommendations
• Infection control guidelines for measles
• Surveillance manual chapter on measles
• What to know about Measles - Protect Yourself and Community