Abstract
Background
It is vital for frontline emergency physicians to immediately recognize the signs
and symptoms of measles to initiate appropriate therapy and prevent spread to the
health care team and other patients.
Objective
This review serves as a clinically practical updated reference for when the differential
diagnosis includes measles.
Discussion
Measles is a highly contagious illness that classically presents with a rash, fever,
cough, coryza, and conjunctivitis. Cases in the United States since 2000 have been
attributed mainly to travelers who are infected abroad and then spread the illness
to small, susceptible populations within the United States. Complications from measles
are relatively common and can be associated with significant morbidity and mortality.
Clinical suspicion should be confirmed with laboratory testing, which is most commonly
a serum immunoglobulin M. The management of measles is mainly supportive. Patients
that require more aggressive management include those who are pregnant, immunocompromised,
or unvaccinated. Treatment may consist of the measles vaccine, intravenous immunoglobulin,
vitamin A, and even ribavirin. Additionally, special precautions are required by hospital
workers to help prevent the spread of the virus, which include N-95 masks and patient
isolation in an airborne infection isolation room.
Conclusion
Emergency physicians must be readily able to identify, contain patients with suspected
measles, and determine who will need further medical management for this potentially
life-threatening illness. As this public health crisis evolves, novel ways of screening
for and reporting cases of measles is needed.
Keywords
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Article info
Publication history
Published online: March 31, 2020
Accepted:
February 16,
2020
Received in revised form:
January 31,
2020
Received:
November 11,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
