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Prevention of Secondary Cases after a Measles Exposure at an Academic Medical Center

Published online by Cambridge University Press:  23 June 2026

Jean Barth
Affiliation:
Mayo Clinic
Leah Siple
Affiliation:
Mayo Clinic
Alyssa Olson
Affiliation:
Mayo Clinic
Jenna Rasmusson
Affiliation:
Mayo Clinic
Rebecca Faller
Affiliation:
Mayo Clinic
Michelle Meyer
Affiliation:
Mayo Clinic
Becky Baxter
Affiliation:
Mayo Clinic
Emily Loberg
Affiliation:
Mayo Clinic
Debra Apenhorst
Affiliation:
Mayo Clinic Rochester
Leah Higbe
Affiliation:
Mayo
Sarah Bellows Mahler
Affiliation:
Mayo Clinic Rochester
Sheila Higbe
Affiliation:
Mayo Clinic
Elena Beam
Affiliation:
Mayo Clinic Rochester
John OHoro
Affiliation:
Mayo Clinic College of Medicine
Emily Levy
Affiliation:
Mayo Clinic
W. Charles Huskins
Affiliation:
Mayo Clinic
Priya Sampathkumar
Affiliation:
Mayo Clinic, Rochester, MN

Abstract

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Background: Measles is a highly transmissible virus. A single case can result in significant exposures within a healthcare facility and prompt action is needed to prevent secondary cases. In October 2025, Infection Prevention and Control (IPAC) was notified of a patient being admitted to our facility with recent international travel and symptoms consistent with measles. The patient was unvaccinated and had five healthcare facility visits prior to measles being suspected and subsequently confirmed. Objective: To describe our facility’s effective identification, prioritization, and prophylaxis of individuals exposed to measles. Methods: IPAC leveraged the electronic medical record to identify potentially exposed patients. Patients were quickly assessed for age and immune status, then prioritized and assigned to primary care teams. These teams promptly contacted patients and coordinated PEP administration. Results: Across five encounters, the index patient exposed 539 other patients. Due to delayed notification, our teams had less than four days to administer PEP for those exposed and still within PEP window. PEP administration began within hours of the index case’s positive test and patients received PEP within three days (Table 1). No secondary measles cases occurred within our facility. Conclusion: Timely and coordinated multidisciplinary effort enabled us to rapidly respond to our first measles case and control secondary transmission. Although the index case resulted in a large exposure, patients that were exposed and eligible for PEP were quickly prioritized to prevent secondary transmission.

A table summarizing data on exposed individuals, their immunity status, and post-exposure prophylaxis measures.

Information

Type
Respiratory Viruses Other than SARS-CoV-2
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America