Be Alert and Aware About Measles Recognition and Testing

The largest measles outbreak in nearly 30 years is occurring in Texas. The Texas Department of State Health Services has confirmed that a “school-aged child who was not vaccinated” in West Texas died following a hospitalization for the measles virus. As of Feb. 26, 124 cases of measles have been identified across nine Texas counties.

In preparation for any such cases at Cook Children’s in our Ambulatory settings, a Clinical Pathway was created and approved in June of 2024. It can be found here: Measles: Lucidchart 

Measles will present with fever and the 3 C’s, cough, coryza, and conjunctivitis. The characteristic rash appears 3-5 days after the start of symptoms and can include an increase in fever. The rash is frequently described as the DRIPPING RASH as it begins on face at hairline and spreads downward. 

Detailed description of testing recommendations for CCMC and non-CCMC sites, which may differ, can be found in the Clinical Pathway. 

Goals for teams include: 
1. Minimize contact of patient with suspected measles from staff, providers and other patients. 
2. Avoid referral to another CCHCS site UNLESS medically necessary for higher level of care. If referral needed contact to CCMC ED must occur so that appropriate referral protocol and isolation can occur. 
3. Ask all patients about immunization status if suspected. 

For questions or concerns surrounding suspected measles contact: 
1. Infection Control -682-885-4000 
2. CCPN Clinical Operations – 682-885-6800 

Thanks for your vigilance! Feel free to reach out if any questions:
Alice Phillips, MD, MPH 
Director of Ambulatory Quality