Measles Referral Guidelines

Measles is a highly contagious viral infection that consists of a fever, cough, coryza (runny nose), conjunctivitis and a distinct rash. It is spread from one child to another through direct contact with secretions from the nose and throat, or via air-borne droplets from an infected child.

After exposure to the disease, it can take between 7 to 21 days for a child to develop symptoms of measles. Children are contagious from 4 days before to 4 days after the rash develops. This means that children can be contagious before anyone knows they have measles.

Caring for Patients With Suspected Cases of Measles

How should I initially evaluate and manage my patient?

Assess the possibility of measles in individuals who are not up to date on their measles vaccination based on age
Consider measles in those with a febrile rash illness along with:
- Cough
- Coryza (runny nose)
- Conjunctivitis
- Recent international travel or travel to a region with recent measles cases

To ensure public health safety, especially for critically ill and immunocompromised patients in local hospitals, contact your local department of health if you encounter a patient with suspected measles. The department of health will guide you on confirming the measles diagnosis and provide information on appropriate follow-up care.

When should I refer my patient to Children’s National Hospital?

For patients needing measles infection testing, please reach out to your local health department.

Healthcare providers should refer patients to Children's National if the patient:

Has moderate or severe measles symptoms and might need hospital admission (providers must contact the infectious diseases doctor on call prior to referral)
Might need measles post-exposure prophylaxis and cannot receive the MMR vaccine, including:
- Infants under 6 months of age
- Immunocompromised patients

How can I refer my patient?

How can I minimize exposure to measles in healthcare settings?

Notify the receiving facility and/or EMS before transport.
Use alternative entrances for patients, avoid waiting rooms, place patients in private rooms, and mask them or cover babies with a blanket immediately.
Ensure only immune healthcare providers interact with suspected measles cases.
Follow standard and airborne precautions. If no airborne isolation room is available:
- Place masked patients in a private room with the door closed.
- Avoid placement where exhaust is recirculated without HEPA filtration.
- Do not use the room for two hours after the patient leaves.

Supporting Your Patient Care

More Provider Resources for Measles

We've compiled information from a measles Town Hall for community healthcare providers that featured Children's National Infectious Diseases Specialist Nada Harik, MD, and more resources that providers may find helpful.

Explore measles resources for providers