Q1 2024 Urgent Caring – Urgent Updates – Stay Alert for Measles Cases

Stay Alert for Measles Cases-CDC Clinician Outreach and Community Activity!

Between December 1, 2023, and January 23, 2024, the Centers for Disease Control and Prevention (CDC) was notified of 23 confirmed U.S. cases of measles, including seven direct importations of measles by international travelers and two outbreaks with more than five cases each. Most of these cases were among children and adolescents who had not received a measles-containing vaccine, even if age eligible. Full Access: CDC

Recommendations for Healthcare Providers 

Isolate

Do not allow patients with suspected measles to remain in the waiting room or other common areas of the healthcare facility; isolate patients with suspected measles immediately, ideally in a single-patient airborne infection isolation room (AIIR) if available, or in a private room with a closed door until an AIIR is available.

Precautions

Healthcare providers should be adequately wearing standard and airborne precautions should be followed, including:

◦  Use of a fit tested NIOSH-approved N95 or higher-level respirator.

◦  Use of additional PPE if needed for task (e.g., gloves for blood draws).

◦  Cleaning hands before and after seeing the patient.

◦  Limiting transport or movement of patients

Notify

Immediately notify local or state health departments about any suspected case of measles to ensure rapid testing and investigation.

Test

Follow CDC’s testing recommendations and collect either a nasopharyngeal swab or throat swab for reverse transcription polymerase chain reaction (RT-PCR), as well as a blood specimen for serology from all patients with clinical features compatible with measles. RT-PCR is available at CDC, at many state public health laboratories, and through the APHL/CDC Vaccine Preventable Disease Reference Centers.

Manage

In coordination with local or state health departments, provide appropriate measles post-exposure prophylaxis (PEP) to close contacts without evidence of immunity, either MMR or immunoglobulin. The choice of PEP is based on elapsed time from exposure or medical contraindications to vaccination.  

Vaccinate

Make sure all your patients are up-to-date on measles vaccine, especially before international travel. People 6 months of age or older who will be traveling internationally should be protected against measles. 

 CDC Respiratory Virus Guidance

Each year, respiratory viruses are responsible for millions of illnesses and thousands of hospitalizations and deaths in the United States. CDC has updated isolation requirements for patients with COVID-19 for non-healthcare workers. Full Access: CDC

US Respiratory Virus Levels Remain High as Flu Rises in Central States

Respiratory illness levels in the United States remained high but stable last week, with flu activity rising in some regions of the country and indicators declining for both COVID-19 and respiratory syncytial virus (RSV). Full Access: CIDRAP

Measles Outbreak Threatens US Status Of ‘Eliminating’ Virus

The rash of measles outbreaks around the country has sparked concerns that the U.S. risks losing its status as a country where the disease has been eliminated, a distinction held since 2000. The CDC recommends people without immunity to measles should isolate after potential exposure for 21 days. Full Access: The Hill

Can AI Tool Improve Dx of Ear Infections?

Out of an original pool of 1561 videos, experts identified acute otitis media in 305 videos (26.5%) and no acute otitis media in 846 videos (73.5%). The tool achieved a sensitivity of 93.8% and specificity of 93.5%, with bulging of the tympanic membrane being the most indicative feature of acute otitis media, present in 100% of diagnosed cases, according to the researchers. Full Access: Medscape

A New Diagnostic Tool for Gonorrhea?

In preliminary studies, a novel point-of-care assay for detecting Neisseria gonorrhoeae accurately identified the infection in 96.5% of symptomatic men and 95.5% of symptomatic women. This test may provide an important addition to the toolbox for diagnosing STIs in the resource-limited settings. Full Access: NEJM

SMART Initiation Low Among PCPs, But Several Interventions Could Improve Adoption

In this study, presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting, only seven out of 22 children initiated on SMART were initiated by a PCP.

The researcher concluded that single maintenance and reliever therapy was not commonly initiated by primary care providers, although PCPs supported efforts to improve adoption.  Full Access: Helio