From the Guidelines
Healthcare workers should wear N95 respirators when caring for patients with suspected or confirmed measles, as this provides the best protection against airborne transmission. According to the Advisory Committee on Immunization Practices (ACIP) recommendations 1, N95 respirators or respirators with similar effectiveness in preventing airborne transmission should be used by all staff entering the room of a person with suspect or confirmed measles, regardless of presumptive immunity status. This is because measles is highly contagious and can spread through airborne transmission, with the virus remaining suspended in the air for an extended period.
When caring for patients with measles, the following personal protective equipment (PPE) is recommended:
- N95 respirator or a respirator with similar effectiveness in preventing airborne transmission
- Medical mask for the patient to wear
- Placement of the patient in an airborne-infection isolation room (i.e., a negative air-pressure room) as soon as possible
- If an airborne-infection isolation room is not available, the patient should be placed in a private room with the door closed and be asked to wear a mask
It is essential to note that standard surgical masks are inadequate for protection against measles, and N95 respirators are the preferred choice 1. Additionally, patients with suspected or confirmed measles should be isolated, and appropriate infection-control measures should be implemented to prevent further spread. Healthcare workers without documented immunity to measles (through vaccination or prior infection) should not care for these patients if possible, and those who are not vaccinated after exposure should be removed from all patient contact and excluded from the facility from day 5 after their first exposure through day 21 after the last exposure 1.
From the Research
Personal Protective Equipment (PPE) for Measles
- N95 respirators (or equivalent) are recommended for healthcare workers (HCWs) when evaluating suspected measles patients, regardless of immunity status 2
- HCWs with direct unprotected exposure to measles patients should be monitored for symptoms and be furloughed at the earliest sign of illness 2
- Standard and expanded precautions, including the use of masks, N95 respirators, eye protection, and gowns, can be effective in preventing the transmission of measles in healthcare settings 3, 4
- Pre-exposure immunization with vaccines, such as the measles, mumps, rubella (MMR) vaccine, is also an important component of an effective infection control program 5, 6, 4
Key Considerations
- Vaccination may lower infectivity, and HCWs should be vaccinated against measles to prevent nosocomial transmission 2, 5, 6
- Strict adherence to standard and expanded precautions among patients and HCWs is essential for preventing the transmission of measles 3, 4
- Timely identification of measles, early public health notification, and complete contact tracing are crucial in preventing further cases 6