The Houston Health Department (HHD) confirmed two measles cases in adult residents living together. The two individuals were unvaccinated and had recently traveled abroad. The department has released a precautionary list of places with potential exposure dates so people who visited these locations should check their vaccination status for measles and monitor for symptoms of illness.
Measles spreads through respiratory transmission via direct contact with droplets or airborne particles released when an infected person breathes, coughs, or sneezes. After an infected individual leaves an area, the virus can linger in the air for up to two hours presenting a substantial danger to unvaccinated individuals. Exposure to the virus leads to symptoms that develop within one to two weeks including high fever, cough, and runny nose accompanied by red watery eyes. The red rash appears a few days after symptoms begin, initially, it appears on the face before spreading across the entire body. An individual remains contagious starting from four days before the rash appears and continues for another four days after it becomes visible.
The HHD urges all its residents to stay up to date with their measles-mumps-rubella (MMR) vaccination. The MMR vaccine offers exceptional protection against measles through two required doses. Vaccinated individuals can still contract measles; however, symptoms are typically milder, and the risk of virus transmission is significantly reduced. Texas Department of State Health Services (DSHS) together with the Centers for Disease Control and Prevention (CDC) recommend giving the MMR vaccine to children at 12 to 15 months of age and then repeating it between ages 4 and 6 years. Children under five years old and individuals with weakened immune systems face the highest risk of complications.
Those exposed to the virus should monitor for symptoms which include increased temperature, coughing, nasal congestion, and skin outbreaks.
Healthcare providers need to treat measles as an active diagnosis when patients show these characteristics:
Fever of 101°F (38.3°C) or higher.
A widespread rash that lasts for three or more days and usually starts at the hairline and then spreads down the body.
Patients may exhibit coughing along with nasal discharge as well as conjunctivitis and sometimes present Koplik spots that appear like bluish-white spots with reddish coloration within the oral cavity.
Medical providers need to immediately contact their health department with suspected measles cases to enable efficient testing and public health responses. Every healthcare facility must establish rigorous infection control procedures to handle confirmed or suspected measles patients. The CDC recommends:
Healthcare facilities need to use airborne infection isolation rooms (AIIR) to isolate infected patients.
When an isolation room is unavailable all affected patients should occupy a separate room with closed doors situated away from vulnerable populations until they can transfer to an appropriate facility.
Healthcare workers who are exposed to measles must provide proof of their immunity against the disease. Employees needing immunity against measles must begin post-exposure prophylaxis immediately and remain off duty until the incubation period ends between days 5 and 21 after exposure.
Wearing medical masks serves as an infection control measure for patients who have active infections to reduce transmissible droplets spread through the air.
Medical staff who acquire measles must stop working for at least four days after the rash appears. The period of work absence for immunocompromised personnel extends beyond standard guidelines. To manage outbreaks the hospitals need to execute recommendations from the CDC Advisory Committee on Immunization Practices (ACIP) regarding MMR vaccine administration to healthcare staff.
The measles testing process needs to commence directly after any suspected measles case detection occurs. The DSHS Laboratory conducts throat swab testing through polymerase chain reaction (PCR) technique along with serology tests on nasopharyngeal swabs and serum specimens. Local health departments must collaborate with providers to arrange testing procedures while maintaining correct specimen processing protocols.
References: Texas Department of State Health Services. Confirmed case of measles – January 2025. Published January 23, 2025. Accessed February 11, 2025. https://www.dshs.texas.gov/news-alerts/confirmed-case-measles-january-2025.
