Measles (Rubeola) Resources for Health Care Providers
Measles cases are rising in the United States and globally.
Prompt recognition, reporting, and investigation of measles cases are important. You can help limit disease spread with vaccines and early case identification.
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For Local Health Departments
Your role as a trusted health professional is critical in helping parents choose vaccines for their child.
The MMR vaccine is the best way to protect against measles. Talk with parents about the importance of the vaccine.
MMR Vaccine Information Statement (PDF)
MMRV Vaccine Information Statement (PDF)
| Number of doses | Effectiveness |
|---|---|
| One dose | 93% |
| Two doses | ≥97% |
Vaccination recommendations
Use the North Carolina Immunization Registry (NCIR) to access MMR coverage of your eligible patient population. One dose of MMR vaccine, or other presumptive immunity, is sufficient for most U.S. adults born in or after 1957.
Health care providers and health departments should not accept verbal reports of vaccination, without written documentation, as presumptive evidence of immunity.
Presumptive evidence of measles immunity:
- Written documentation of:
- One or more doses of a measles-containing vaccine administered on or after the first birthday for preschool-age children and adults not at high risk
- Two doses of a measles-containing vaccine, administered at least 28 days apart, for school-age children and adults at high risk, including college students, health care workers and international travelers
- Birth before 1957
- Laboratory evidence of immunity
- Laboratory confirmation of disease
The Centers for Disease Control and Prevention (CDC) recommends children routinely get two doses of MMR vaccine:
- First dose at age 12-15 months
- Second dose at age 4-6 years (before school entry)
Travel recommendations
All U.S. residents 6 months and older without evidence of immunity who are planning to travel internationally or to U.S. areas with known outbreaks should get the MMR vaccine before departure.
| Age | Doses |
|---|---|
| Infants 6-11 months | One dose MMR before departure Infants who get the MMR vaccine before their first birthday should get two additional doses as part of the routine childhood immunization schedule, beginning at 12-15 months. |
| Children 12 months and older | Two doses of MMR, at least 28 days apart, before departure |
| Teens and adults without evidence of measles immunity | Two doses of MMR, at least 28 days apart, before departure |
People exposed to a confirmed case of measles may be eligible for post-exposure prophylaxis (PEP) if they do not have evidence of immunity.
Types of PEP for Measles
- MMR vaccine, if administered within 72 hours of exposure
- Immunoglobulin (IG), if administered within six days of exposure. IG is recommended for people at high risk of complications, including:
- Infants younger than 12 months*
- Pregnant women
- People who have compromised immune systems, regardless of vaccination status
*In a measles outbreak setting, infants 6-11 months can get MMR vaccine in lieu of IG if administered within 72 hours of exposure.
Don't administer MMR vaccine and IG at the same time. This practice invalidates the vaccine.
More information: Measles Vaccine Recommendations (CDC)
- Fever, Rash and Travel? Consider Measles (PDF)
- Think Measles: Clinician Job Aid (American Academy of Pediatrics) (PDF)
Suspect measles? Call the state Communicable Disease Branch at 919-733-3419 (available 24/7) or your local health department to discuss lab testing and control measures.
Reduce exposures in health care settings as much as possible before and upon arrival of a patient with a known or suspected measles case.
- Notify EMS and/or the receiving facility before transporting or referring patients.
- Have patient use alternative entrance, avoid placing patient in a waiting room, place patient in a private room immediately, and mask patient as soon as possible. This helps avoid exposing others.
- Post visual alerts and instructions at entry points.
- Prepare triage stations to rapidly identify patients with measles.
- Adhere to standard and airborne precautions for patients with known or suspected measles. If an airborne isolation room is not available:
- Place the masked patient in a private room with the door closed.
- Preferably, avoid placement where room exhaust is recirculated without high-efficiency particulate air (HEPA) filtration
- Do not use the room for two hours after the patient leaves.
Laboratory Testing
The most common methods for confirming measles infection are detection of:
- Measles virus RNA via polymerase chain reaction (PCR)
- Measles-specific IgM antibody
Testing through the State Laboratory of Public Health (SLPH)
SLPH offers measles PCR testing on-site and send-out testing, including serology and vaccine RNA testing for situations involving recent vaccination. Some commercial laboratories also offer testing for measles serology and PCR. In most circumstances, testing through SLPH is much faster than commercial testing.
You must get prior approval to test through SLPH: Call the state Communicable Disease Branch at 919-733-3419 (available 24/7) or your local health department.
More Resources
Provider Memo: Measles reporting, testing and vaccination (PDF) - 3/3/25
More Information from the CDC
This page was last modified on 03/27/2025