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.
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
United States Risk Assessment
The following resources are intended for health departments, clinicians, and the general public.
Measles Information
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
| Document | Purpose |
| 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
| Document | Purpose |
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
| Document | Purpose |
| 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. |
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
| Document | Purpose |
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
| Document | Purpose |
| 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
| Document | Purpose |
| 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
Infographics
Factsheets
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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.