A health alert issued by the Texas Department of State Health Services (DSHS) advises physicians to consider measles in their diagnoses. The department published the alert following notification by the Kansas Department of Health and Environment that more than 30 Texans may have been exposed to the highly contagious disease at a Wichita, Kan., softball event during the Fourth of July weekend.
At least three Texas recreational softball teams traveled to Wichita to participate in a tournament, held at the South Lakes Sports Complex. DSHS is investigating to determine who may have been exposed.
The department has not yet identified any Texas measles cases associated with the event. Last year, there were 27 reported measles cases in Texas and none in 2012.
The alert urges health care professionals, hospitals, laboratories, schools, childcare facilities, and others to report to local health departments patients suspected of having measles, as required by Texas law. Lab confirmation isn't required to report measles suspects, and reports can be made by calling (800) 705-8868.
According to the alert, the measles incubation period is about two weeks from exposure to onset of rash but may be as short as one week or as long as three weeks. People are contagious from four days before onset of rash to four days after the appearance of rash. The rash usually begins on the face and spreads to the trunk. Other symptoms include fever (higher than 101 degrees), cough, runny nose, and sore eyes.
The alert includes information on measles testing, prophylaxis, and exclusion criteria. Postexposure prophylaxis recommends measles, mumps, rubella (MMR) vaccine for those exposed (6 months and older) without evidence of immunity to measles. MMR vaccine should be administered within three days of exposure.
Physicians should check all patients' vaccination history and offer vaccine to anyone who is not up to date with the vaccine schedule, the alert states.
The alert's guidance on health care worker immunity advises all health facilities to ensure they have current documentation of measles immunity status for all staff members - not just health care professionals. Documentation of immunity includes:
- Birth prior to 1957,
- Written record of receipt of two doses of MMR vaccine, or
- Positive serological titers.
Exposed health care workers without documented immunity should be excluded from work from days five to 21 after exposure.
DSHS urges anyone in Texas who attended the Wichita softball event to call the department at (512) 776-7676 to report the potential exposure.
Action - July 18, 2014