What preventive measures can be taken for unvaccinated children during a measles outbreak?

From the Guidelines

To prevent measles in unvaccinated children during an outbreak, the most effective immediate action is to get them vaccinated with the MMR (measles, mumps, rubella) vaccine as soon as possible, as it can provide some protection even when given within 72 hours of exposure to the virus 1.

Key Considerations

• The MMR vaccine is the preferred method of prevention for most persons aged greater than or equal to 12 months who are exposed to measles in most settings, including day care facilities, schools, colleges, and health-care facilities 1.
• For susceptible persons aged greater than or equal to 6 months who are household contacts of measles patients, use of vaccine within 72 hours of initial exposure is also acceptable 1.
• However, for infants less than 6 months of age, immune globulin (IG) may be indicated if they are susceptible household contacts of measles patients, particularly if the risk for complications is increased 1.

Additional Measures

• Until vaccination is possible, keep your children away from public gatherings and potential exposure sites to minimize the risk of infection.
• Practice strict hygiene measures, including:
  • Frequent handwashing with soap and water
  • Avoiding sharing utensils or drinks
  • Disinfecting commonly touched surfaces
• If your child has been exposed to measles, contact your healthcare provider immediately as they may recommend IG within 6 days of exposure, which can prevent or reduce the severity of measles.

Important Notes

• Measles is extremely contagious, spreading through airborne particles that can remain infectious for up to two hours in the air.
• The virus has a 90% infection rate among unvaccinated people who are exposed, which is why vaccination is so crucial.
• Symptoms typically appear 7-14 days after infection and include high fever, cough, runny nose, red eyes, and a characteristic rash.

From the Research

Preventing Measles Outbreak

To prevent measles outbreak in unvaccinated kids, consider the following measures:

• Ensure all children receive two doses of measles-containing vaccine, as most measles vaccine failures are attributable to failure to respond to the first dose 2
• Administer the second dose of MMR vaccine at school entry (4 to 6 years of age) to help prevent school-based outbreaks 2
• Review the records of all children 11 to 12 years of age to ensure they have received two doses of MMR vaccine after their first birthday 2
• Follow the current recommendations for the prevention of measles, rubella, congenital rubella syndrome, and mumps, which include 2 doses of MMR vaccine routinely for children with the first dose administered at age 12 through 15 months and the second dose administered at age 4 through 6 years before school entry 3

Post-Exposure Prophylaxis

In the event of exposure to measles, consider the following post-exposure prophylaxis measures:

• Administer MMR vaccine or immune globulin (IG) to nonimmune contacts, which has been shown to be effective in preventing measles 4
• The effectiveness of MMR post-exposure prophylaxis was 83.4%, while IG post-exposure prophylaxis was 100% effective in preventing measles 4
• Administer IG to infants aged birth to 6 months exposed to measles, and consider using IGIV for severely immunocompromised persons and pregnant women without evidence of measles immunity who are exposed to measles 3

Vaccine Safety

Note that there is no conclusive evidence to support a link between measles vaccination and autistic disorder, although one study suggested a possible association between acetaminophen use after MMR vaccination and autistic disorder 5