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COUNTY OF LOS ANGELES DEPARTMENT OF HEALTH SERVICES OFFICE OF MANAGED CARE Bulletin No: 04-11 April 22, 2004 Provider Bulletin MEASLES ALERT LOS ANGELES COUNTY PUBLIC HEALTH URGES INCREASED VIGILANCE FOR MEASLES We have just been advised that a passenger traveling on China Southern flight # 327, which arrived into Los Angeles (LAX) on March 26, 2004, was likely infectious for measles. The passenger has been confirmed as a measles case. It is very important that health care providers increase their suspicion for measles over the next few days and weeks, when evaluating any person for a rash illness who has not been vaccinated against measles. Measles is a highly communicable disease, and infected persons are capable of transmitting it to others beginning four days before the onset of the rash through the fourth day of rash. The average incubation period from exposure to rash onset is 14 days. Symptoms usually begin 10 to 12 days after exposure with a prodrome of fever, malaise, cough, coryza, and conjunctivitis. Two to four days following onset of the prodrome, a maculopapular rash develops. The rash usually begins at the hairline and lasts 5 to 6 days. Health care providers should obtain a blood specimen for serologic confirmation of the diagnosis. The blood specimen should be obtained four or more days after the onset of the rash and should be tested for measles IgM and IgG antibodies. (With increased sensitivity of many current IgM tests, specimens obtained at the time of diagnosis will often be IgM positive.) Patients with a rash-illness who need medical attention should not be allowed in patient waiting areas. They should be placed immediately in an examination room. The examination room in which a patient with suspected or confirmed measles was examined should not be used again for two hours. If a patient with suspected or confirmed measles requires hospitalization, the patient should be admitted into respiratory isolation. A listing of all exposed patients and staff will be required by the health department from any medical facility with a case of measles. Please call the Morbidity Central Reporting Unit immediately at 888-397-3993 to report any suspected or confirmed measles cases. Before 7:30 am and after 5:00 pm on weekdays, and on weekends call 213-974-1234. For additional information, you can call the Los Angeles County Immunization Program at 213-351-7800. Source: Letter dated April 21, 2004, Immunization Program, County of Los Angeles Department of Health Services Public Health Community Health Plan is an affiliate of L.A. Care Health Plan in providing Medi-Cal Managed Care coverage in Los Angeles County.
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