Healthcare-associated Exposure to Measles, Mumps, or Rubella Viruses

If measles, mumps, or rubella exposure occurs in a healthcare setting, all case-patient contacts should be evaluated immediately for presumptive evidence of measles, mumps, or rubella immunity.¹⁰ Persons are considered immune only if they have documentation of:

1. Laboratory confirmation of measles, mumps, or rubella infection

   or

2. laboratory evidence of measles, mumps, or rubella immunity

   or

3. appropriate vaccination against measles, mumps, and rubella

   or

4. birth before 1957.

Measles

The measles virus is transmitted from person-to-person primarily by direct contact with respiratory secretions or by inhalation of airborne droplets generated by coughing or sneezing. Exposed HCP without evidence of immunity to the measles virus should be offered PEP, preferably MMR vaccine within 72 hours of initial exposure, or immunoglobulin (IG) within six days of exposure. The simultaneous administration of the MMR vaccine and IG invalidates the vaccine.¹¹ Available data suggests that the live measles vaccine, if administered promptly after exposure, will prevent or modify the disease.¹⁰ Exposed HCP should be closely monitored for sign(s) of illness.

Mumps

The mumps virus is transmitted from person-to-person primarily by direct contact with saliva or by inhalation of airborne droplets generated by coughing or sneezing. Exposed HCP without evidence of immunity to the mumps virus should be offered the MMR vaccine.¹⁰ However, antibodies develop too slowly the mumps component of the vaccine to provide effective prophylaxis after exposure. The efficacy of IG has not been established and it is not recommended for postexposure prophylaxis for mumps. Exposed HCP should be closely monitored for sign(s) of illness.

Rubella (German measles)

The rubella virus is transmitted from person-to-person primarily by direct contact with respiratory secretions or by inhalation of airborne droplets generated by coughing or sneezing. There is no evidence that postexposure vaccination is effective in preventing rubella infection. IG administered within 72 hours of exposure might reduce the risk, but does not eliminate it (infants with congenital rubella have been born to women who received IG shortly after exposure).¹⁰ Exposed HCP should be closely monitored for sign(s) of illness.