COUNTY OF LOS ANGELES DEPARTMENT OF HEALTH by jennyyingdi

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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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