Due to the recent measles outbreak that has occurred, healthcare professionals such as nurses, should be aware of symptoms and how to effectively manage their risk of exposure to the disease when at work. 

<p>On the heels of the worst measles outbreak the United States has seen in more than 25 years, we thought we’d share some of the CDC’s (Centers for Disease Control and Prevention) latest information about this disease to ensure our nurses have all the information they need to stay safe, as well as legally compliant with CDC measles vaccine recommendations for adults. Additionally, you’ll want to know about any medical exemption for vaccines, and how to prevent measles after exposure to the virus, and whether that’s even possible.</p>

<h2>What is Measles?</h2>
<p>Measles, caused by the Rubeola virus, has been around since at least the 9th century, but U.S. healthcare providers weren’t required to report diagnosed cases until 1912. During the first ten years of reporting, 6,000 measles-related deaths were reported annually, on average. The measles vaccine, which was developed in the United States, was finally made available in 1963. In the ten years prior, three to four million people were infected with measles annually in the United States, with 4-500 of them dying, 48,000 hospitalized and 1,000 contracting measles-related encephalitis. The CDC set a goal in 1978 to eliminate measles from the United States by 1982. Although the timeline proved difficult, measles was finally declared eliminated in 2000, thanks to the United States’ highly effective vaccination program.</p>

<h2>What Are the Signs and Symptoms of the Measles Virus?</h2>
<p>Measles symptoms, which usually begin about 10-14 days after exposure, include what many medical professionals refer to as the four Ds and the three Cs: a four-day fever, and cough, coryza and conjunctivitis. Then, there is the characteristic maculopapular rash that starts on the back of the ears and spreads throughout most of the body within days of fever onset, lasting up to eight days in total. In a relatively healthy person with access to quality medical care, the disease usually resolves itself within about three weeks. Complications can be deadly for children, pregnant women and those with compromised immune systems.</p>

<h2>Do I Need a Booster Vaccine if I Was Vaccinated as a Child?</h2>
<p>If you’re like most nurses, the recent outbreaks of measles reported in the news probably made you ask yourself about current measles exposure protocol. Even if you remember being vaccinated as a child, can you get measles after vaccine protocol has been followed? Healthcare personnel born before 1957 or those who have received two doses of measles vaccine (whether as a child or as an adult) are considered permanently protected from measles by the CDC and a booster vaccine is not required. If you are unsure whether you are immune to measles and don’t have access to your vaccination records, you should get vaccinated with the measles-mumps-rubella (MMR) vaccine. Even if you were previously vaccinated, there is no harm in receiving an extra dose. Although states have different requirements when it comes to vaccinations and allowed exemptions, most healthcare facilities require employees to be vaccinated. Always stay up to date on your current facilities’ individual policy.</p>

<h2>Recent Measles Outbreaks Across the United States</h2>
<p>After measles was declared eliminated in 2000, approximately 50-200 cases were reported per year throughout the United States over the next decade. In 2014, those numbers increased dramatically, with nearly 700 reported cases, and after a brief respite, those numbers would continue to climb. Between January 1 and August 8, 2019, nearly 2,000 individual cases of measles were confirmed in 30 states. These increases are largely attributed to a current deluge of vaccine misinformation spreading throughout social media channels online. Some cases of measles are also brought into the United States by non-immune individuals traveling to countries currently experiencing outbreaks.</p>

<h2>How Can Nurses Manage Their Exposure to Measles Within a Hospital Setting?</h2>
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With so much misinformation about the measles vaccine currently circulating, it is increasingly likely that nurses may be exposed to the disease on the job. Additionally, according to the CDC, measles travel to the United States from other countries experiencing outbreaks. As long as you have been properly vaccinated, there is no risk in you catching or spreading the disease. In cases of unvaccinated patients being exposed to the virus, it is possible for the measles vaccine to protect low-risk individuals if they receive it within 72 hours of exposure. However, it is important to know the measles policy and procedures in place at your current healthcare facility. Additionally, find out what are vaccine exemptions specific to the state in which you are currently working. More information about state law and vaccine requirements, as well as exemptions allowed in individual states, can be found <a href="https://www.nvic.org/vaccine-laws/state-vaccine-requirements.aspx">here</a>.
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How Nurses Can Manage Their Exposure to Measles