Identify-Isolate-Inform: A tool for initial detection and management of measles patients in the emergency department

Abstract

Measles (rubeola) is a highly contagious airborne disease that was declared eliminated in the U.S.in the year 2000. Only sporadic U.S. cases and minor outbreaks occurred until the larger outbreakbeginning in 2014 that has become a public health emergency. The "Identify-Isolate- Inform" toolwill assist emergency physicians to be better prepared to detect and manage measles patientspresenting to the emergency department. Measles typically presents with a prodrome of high fever,and cough/coryza/conjunctivitis, sometimes accompanied by the pathognomonic Koplik spots.Two to four days later, an erythematous maculopapular rash begins on the face and spreads downthe body. Suspect patients must be immediately isolated with airborne precautions while awaitinglaboratory confirmation of disease. Emergency physicians must rapidly inform the local public healthdepartment and hospital infection control personnel of suspected measles cases.