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Measles Viral Particle

Measles Outbreak Response

Empowering Outbreak Response: Optimizing Strategies for Measles Outbreaks

CORI is actively engaged with state and local health departments responding to and preparing for measles outbreaks. We develop tailored tools aimed at optimizing every stage of the outbreak response process.

We collaborate with local and state health departments to identify:

  • Gaps in preparedness
  • Opportunities for community outreach
  • Data analytics tools and processes
  • Various other facets crucial to outbreak management.

The goal is to seamlessly integrate advanced analytics into decision-making processes at all levels, empowering public health officials with the necessary tools and training to effectively respond to infectious disease outbreaks.

Contact us to learn how CORI can support your outbreak response team.  *Please include Outbreak Response Strategy as your subject line.

The dashboard displays best if viewed on larger screens(Tablet, Laptop & Desktop).

Measles Dashboard

Measles Dashboard FAQ

Why is the data in the Center for Outbreak Response Innovation’s (CORI) measles dashboard different from other dashboards? 

CORI uses multiple data sources to develop our measles tracker. We draw on federal data, health department information, media reports, and other data sets to provide a timely snapshot of what is happening across the U.S. and through recent cases at a jurisdictional level. CORI also reports on measles cases in Canada and Mexico, using government sources. We want to provide relevant, timely, and easy to use data to help people make informed decisions. In collecting and analyzing disease and outbreak data, it is not uncommon for groups to use different data sets, look at trends over different periods of time, and/or focus on specific population groups, which can give different views.

How does CORI maintain its measles dashboard?

CORI seeks to develop innovative and timely tools, like the measles dashboard, to track and respond to disease outbreaks. While the completeness of collected information can vary by jurisdiction, CORI prioritizes state and local health department data, which we validate on a daily (Monday to Friday) basis to ensure the measles dashboard is as current and accurate as possible. We then cross-check against CDC’s national totals. This approach means we sometimes capture cases earlier or later than CDC’s aggregated reporting schedule depending on reporting rates. We aim to align our updates within hours of CDC data release and no later than by the end of the day. Only in the event of a discrepancy or a data gap, which has not been formally reported by a state or local health department or other public health entity, do we use local news reports and other informal sources.

Measles Outbreak Risk Assessment

Measles Epidemiological Background

Measles, a highly contagious viral disease, has been experiencing a concerning resurgence globally and in the United States in recent years. Despite the availability of a safe and effective vaccine, outbreaks continue to occur, primarily due to gaps in vaccination coverage and the virus's high transmissibility. In 2019, the World Health Organization (WHO) reported a significant increase in measles cases worldwide, with 869,770 cases reported in that year alone, the highest number since 1996. This trend has worsened following the COVID-19 pandemic due to disruptions in vaccination efforts and surveillance activities combined with increased vaccine hesitancy, misinformation about vaccine safety, inadequate access to healthcare services, conflict, and humanitarian crises. 

Click here to view full background

Measles Risk Assessment FAQ

Is getting sick with measles naturally better than the measles vaccination? Should I expose myself or my child to measles?

No, getting sick with measles is not better than getting the measles vaccine. While a measles infection does provide natural immunity, it comes with serious risks, including hospitalization, pneumonia, encephalitis (brain inflammation), complications during pregnancy, and even death. Long-term complications include immune amnesia, which can weaken immunity and increase vulnerability to other infections, and subacute sclerosing panencephalitis (SSPE), a rare but fatal brain disease that can develop years after infection.

The measles vaccine provides strong, safe immunity without these risks. Attending a “measles party” to intentionally expose yourself or a child to measles is dangerous and not recommended. It puts individuals at unnecessary risk of severe illness and complications. The best protection for yourself and your community is vaccination.

Can Vitamin A or cod liver oil prevent or cure measles?

No, vitamin A and cod liver oil (which is rich in vitamin A) do not prevent or cure measles. The measles vaccine is the only way to prevent measles. There is no specific treatment for measles, only supportive care.

However, vitamin A supplementation may reduce measles severity and risk of complications, including death. The CDC and American Academy of Pediatrics recommend vitamin A for children with measles, especially if hospitalized. There is no CDC recommendation for the use of cod liver oil as part of measles supportive care.

Since excessive vitamin A intake can be harmful, supplementation should only be given when medically necessary and under the supervision of a healthcare provider. Most children in the US receive sufficient vitamin A through their diet.

Can measles vaccine cause autism?

No. Studies have repeatedly shown no link between the measles vaccine and autism.

Does a positive IgG test mean someone has a measles infection?

No, a positive IgG test indicates immunity to measles from past infection or vaccination, not an active infection. 

Can measles vaccine cause measles illness?

No, the measles vaccine cannot cause measles illness. The MMR vaccine contains a weakened, non-infectious strain (MeVA, genotype A), which does not cause or spread measles but helps the body develop immunity. No human-to-human transmission of the measles vaccine virus has ever been reported.

The current Texas outbreak is linked to a naturally circulating, disease-causing strain (wild-type, genotype D8), which has been circulating since 1990 in regions including Europe, North Africa, the Middle East, and Southwest Asia.

Are measles boosters recommended?

There are currently no recommendations to receive a third dose of MMR vaccine during measles outbreaks. 

During measles outbreaks, state and local health departments may adjust or implement temporary accelerated vaccination schedules, in addition to routine recommendations, for populations at-risk who are residing in or visiting the affected areas. This may include recommending:

  • Infants (6–11 months old): Early dose, followed by routine two-dose series at 12–15 months and 4–6 years, per CDC guidelines.
  • Children (1–4 years old): Early second dose, at least 28 days after the first.
  • Adults: Second dose if only one dose was received, given at least 28 days after the first.
  • Healthcare personnel in a healthcare facility or facilities serving outbreak areas are recommended to receive two MMR doses regardless of birth year if they lack laboratory-confirmed immunity.

The following populations, aged 12 months of age or older, are recommended to receive at least two doses of MMR vaccine, at least 28 days apart, if they lack measles immunity:

Certain populations may benefit from an additional MMR dose or revaccination:

CLICK HERE TO DOWNLOAD AND VIEW REFERENCES

The following resources are intended for health departments, clinicians, and the general public. 

Measles Modeling and Analytics Tools
Tool Purpose 
epiENGAGE Measles Outbreak Simulator The tool simulates the spread of measles in a single school given information about the number of students, the vaccination rate in the school, and the number of cases. Public health officials can use it to communicate outbreak risks to schools and government leaders, highlighting how even small decreases in vaccination coverage can significantly increase the likelihood of an outbreak. 
Health Department Outbreak Response Templates

Overview: The following outbreak response templates were developed by CORI in collaboration with health department partners and aim to standardize measles outbreak responses and reduce the staff time required to mount an initial response. These templates are provided as a general guide and should be tailored to meet the specific requirements and regulations of your local or state health department or relevant authorities. It is crucial that the content and instructions align with current guidelines and legal standards established by your jurisdiction.

Case Investigation Templates 

DocumentPurpose 
REDCap Template Request FormThis survey provides REDCap templates for measles case investigation and contact monitoring
Isolation Letter [CORI]Inform individuals diagnosed with measles about isolation 
Quarantine Letter [CORI]Notify individuals who have been exposed to measles of the need to quarantine

Symptom Monitoring Letter [CORI]

 

Notify individuals who may have been exposed to measles and have adequate protection against measles on how to monitor their symptoms

 

Communication Templates

DocumentPurpose 

Press Release [CORI]

 

Communicate possible measles exposures to alert the general public

Clinician Alert Letter [CORI]

 

Inform healthcare providers of a measles outbreak and provide guidance on clinical practices, reporting, and precautions

School Exposure Notification Letter [CORI]

 

Notify families about a confirmed or potential measles exposure within the school environment

 

Operational Workflows 

DocumentPurpose 
Measles Workflow 1 [Public Health- Seattle & King County]This workflow describes the general steps and teams involved in a measles response after being notified by a healthcare provider or facility that a patient presents with symptoms of measles and requires testing.
Measles Workflow 2 [Public Health- Seattle & King County]This workflow describes the general steps and teams involved in a measles response after a positive laboratory result and have a confirmed case.
Measles Workflow 3 [Public Health- Seattle & King County]This workflow covers the general steps and teams involved in holding a mass vaccination event as part of the measles response.
Measles Workflow 4 [Public Health- Seattle & King County]This workflow covers the general steps and teams involved in providing IG for passive immunization during measles response.
Measles Workflow 5 [Public Health- Seattle & King County]This workflow describes the general steps and teams involved in a measles response to assess immunity of persons exposed to measles. Immunity can be determined through vaccination records, documentation of illness, or serology-based titer results.

Templates for Public Health Preparedness Offices 

The following resources have been provided by the Jefferson County Health Department (MO), and have been tested through exercises and real-world responses.  

Document Purpose 
Capability 3: Emergency Operations Coordination  Template Capability 3 Plan for Emergency Operations Coordination to provide health departments updating or reorganizing their plan with a starting point that has already been developed and tested.  
Concepts of Operations  Template Concept of Operations reference tool to provide health departments updating or reorganizing their plan with a starting point that has already been developed and tested. 
COOP- Continuity of Operations Template Continuity of Operations Plan to provide health departments updating or reorganizing their plan with a starting point that has already been developed and tested. 
Measles Tabletop Exercise After Action Report/Improvement Plan Template Measles Tabletop Exercise used by Jefferson County in 2024 to prepare for a potential measles outbreak. This template can be used and adapted by health departments to prepare a potential measles outbreak in their jurisdiction. 
Measles Tabletop Exercise Power Point Presentation Template Measles Tabletop Exercise (TTX) power point used by Jefferson County to facilitate a TTX in 2024. This template can be used and adapted by health departments to prepare a potential measles outbreak in their jurisdiction. 
Measles Tabletop Exercise Facilitator Guide Template Measles Tabletop Exercise (TTX) facilitator guide used by Jefferson County to facilitate a TTX in 2024. This template can be used and adapted by health departments to prepare a potential measles outbreak in their jurisdiction. 
Measles Tabletop Exercise Evaluator Guide Template Measles Tabletop Exercise (TTX) evaluator guide used by Jefferson County to evaluate a TTX in 2024. This template can be used and adapted by health departments to prepare a potential measles outbreak in their jurisdiction. 
Measles Tabletop Exercise Situation Manual Template Measles Tabletop Exercise (TTX) situation manual used by Jefferson County to facilitate a TTX in 2024. This template can be used and adapted by health departments to prepare a potential measles outbreak in their jurisdiction. 
Measles Exposure Investigation Flow Chart Sample measles exposure investigation flow chart that has been tested and used in a real-world response. This template can be used and adapted by health departments to response to measles in their jurisdiction 
PHEOC Event Log Template Sample Public Health Emergency Operations Coordination (PHEOC) event log that has been tested and used in a real-world response. This template can be used and adapted by health departments to response to measles in their jurisdiction. 

 

 

Health Department Outbreak Response Toolkits

Overview: The following guidance and educational materials have been developed by CORI, CDC, state and local health departments to support providers and clinic administrators prepare for, recognize, and respond to measles. 

Case Investigation Tools and Protocols

DocumentPurpose 

Measles Case Investigation Form with Script  [CDC]

 

Guide health department staff in conducting and documenting investigations of measles cases

Measles Monitoring Form with Script [CDC]

 

Guide health department staff in monitoring and documenting the health status of individuals exposed to measles

Measles Case Line List [CDC] 

 

Provide a structured tool for recording and managing details of measles cases and contacts
Measles Local Health Department Protocol [LA County Department of Public Health]Provides an example step-by-step guide for responding to a measles case

 

Toolkits for Local Health Departments

Document Purpose  
Measles Toolkit for Local Health Departments [TN Department of Health] Provides key information for local health departments leading their own measles outbreak response 
Measles Communication Toolkit [Texas Health and Human Services] Provides key measles-related communication materials including: a press release, letter to physicians, exposure notification letters for schools and healthcare settings, and other helpful resources. 

 

Toolkit for School Nurses

Document  Purpose   
Table of Contents: School Nurse Toolkit  [Public Health – Dayton & Montgomery County]Table of contents to orient users to the toolkit.
Measles Guidance for Schools 2024 [Public Health – Dayton & Montgomery County]Three-page overview of actions that can be taken by schools to prevent, prepare for, and respond to measles.
For Nurses: Infectious Disease Reporting Guidelines for Healthcare Providers [Public Health – Dayton & Montgomery County]Two-page summary of who should report what, by when, why, and how.
For Nurses: Example ABCs Guide to Reporting [Public Health – Dayton & Montgomery County]Two-page printout for nurses regarding which disease are reportable and by class.
For Nurses: Example Confidential Reporting Form [Ohio Department of Health]Example reporting form for reportable diseases.
For Nurses: Measles FAQ [Public Health – Dayton & Montgomery County]Clinically-focused three-page FAQ document 
For Health Departments: Health department notification letter to principals of a measles case in the county [Public Health – Dayton & Montgomery County]One-page letter to schools from a health department regarding recommend actions to prevent measles.
For Administration: Principal to Parent Notification Letter Sample [Public Health – Dayton & Montgomery County]One-page letter to parents from the school administration to inform them of a measles exposure.
Measles FAQ for Parents and Students [Public Health – Dayton & Montgomery County] Five-page FAQ document about measles transmission, symptoms, and vaccination.
InfoSheet for Students and Parents: What to Know if You’re Exposed to Measles [Public Health – Dayton & Montgomery County]In depth guide for individuals who have been notified that they have been exposed to measles.
InfoSheet for Students and Parents: Measles Vaccine Flyer     [Public Health – Dayton & Montgomery County]One-page flyer to promote information about a walk-in vaccine clinic.
InfoSheet for Students and Parents: It is Not Just a Little Rash    [Public Health – Dayton & Montgomery County]One-page infographic to address misconceptions and raise awareness about the complications of measles  

 

Clinical Guidance and Educational Materials

Overview: The following guidance and educational materials have been developed by CORI, CDC, state and local health departments to support providers and clinic administrators prepare for, recognize, and respond to measles. 

Guidance Documents 

DocumentPurpose 
Outpatient Infection Control Guide [CDC] Provide clinic administrators with guidance regarding infection control

Measles: Skin Assessment Guidance [CORI]

 

Support providers in the identification of measles, especially on different skin tones 

Measles Assessment Checklist for Providers [Washington State Health Department]

 

Support providers in recognizing and documenting measles symptoms
Clinical Provider Flowsheet  [CDC]Guide providers in evaluating a patient presenting with rash and fever
Example Measles Provider Algorithm [TN Department of Health] An example visual diagram to guide providers on when to test for measles 
Example Provider Algorithm: “Should I Test for Measles?” [California Department of Health]

An example visual diagram to guide providers on when to test for measles

 

Example Protocol for Measles Specimen Routing [Alameda County Health Department]An example protocol to support clinical staff in properly routing the specimen to the public health lab
Measles Healthcare Exposure Investigation Quicksheet [California Department of Health]Support providers and healthcare administrators in triaging and evaluating measles, implementing infection control measures, initiating an exposure investigation, and assessing immunity of contacts.

 

Office Materials for Patients

DocumentPurpose 
Informational Sheet for Patients [Washington State Health Department]Provide patients with an overview of measles 

Measles Informational Poster [Washington State Health Department]

 

Promote awareness of measles symptoms among parents; intended to be posted at the entrance of clinic waiting rooms

 

Key Information for the General Public

Background: Public health agencies are facing the re-emergence of measles in the US, with multiple large clusters already reported in 2024. Because measles is highly infectious and transmissible, responding to even a single case requires significant investment of time, money, and people power. This is a substantial burden for health departments already facing stretched resources and staff burnout amid the aftermath of the COVID-19 pandemic, a strained healthcare system, and the pressures to address various other communicable diseases.