Health Alert Network (HAN) — March 3, 2023

For more information, please contact:

Jackson County Health Department

Epidemiology Division

[email protected] | (816) 404-9898

Health Advisory: Measles Exposure at a Large Gathering in Kentucky (Feb. 2023) and Global Measles

Good afternoon —

The Jackson County Health Department’s Communicable Disease Epidemiology Program would like to bring your attention to a recent Health Alert Network (HAN) Official CDC Health Advisory, which notifies clinicians and public health authorities of a measles exposure at a large gathering in Kentucky. 


The full health advisory can be read here. The key points covered in the update are as follows:


  • On February 24, 2023, the Kentucky Department for Public Health (KDPH) identified a confirmed case of measles in an unvaccinated individual with a history of recent international travel.
  • While infectious, the individual attended a large religious gathering on February 17–18, 2023, at Asbury University in Wilmore, Kentucky.
  • An estimated 20,000 people attended the gathering from Kentucky, other U.S. states, and other countries during February 17–18, and an undetermined number of these people may have been exposed.
  • CDC recommends that clinicians be on alert for cases of measles that meet the case definition.


Recommendations for Healthcare Providers:


  • Consider measles as a diagnosis in anyone with a febrile illness and clinically compatible symptoms (e.g., rash, cough, coryza, or conjunctivitis) who:

  • attended the Kentucky event during the exposure dates of February 17 or 18 or has had contact with an attendee.
  • has recently traveled abroad, especially to countries with ongoing outbreaks.
  • Immediately notify local or state health departments about any suspected case of measles to ensure rapid testing and investigation.
  • Recommend MMR vaccine for patients who are unvaccinated or not fully vaccinated.
  • Do not allow patients with suspected measles to remain in the waiting room or other common areas of the healthcare facility; isolate patients with suspected measles immediately, ideally in a single-patient airborne infection isolation room (AIIR) if available.
  • Follow CDC’s testing recommendations and collect either a nasopharyngeal swab, throat swab, or urine specimen for Reverse Transcription Polymerase Chain Reaction (RT-PCR) as well as a blood specimen for serology from all patients with clinical features compatible with measles. RT-PCR is available at many state public health laboratories and through the APHL/CDC Vaccine Preventable Disease Reference Centers. Nasopharyngeal or throat swabs are preferred over urine specimens.

  • Collect the first (acute-phase) serum specimen (IgM and IgG) as soon as possible upon suspicion of measles disease. If the acute-phase serum specimen collected ≤3 days after rash onset is negative and the case has a negative result for real-time RT-PCR (rRT-PCR), or one was not done, a second serum specimen collected 3–10 days after symptom onset is recommended because the IgM response may not be detectable until 3 days after symptom onset.
  • HCP should use respiratory protection (i.e., a respirator), that is at least as protective as a fit-tested, NIOSH-certified disposable N95 filtering facepiece respirator, regardless of presumptive evidence of immunity, upon entry to the room or care area of a patient with known or suspected measles.
  • Contact your state or local health department to determine where to submit specimens and how to ship them.
  • Ensure all patients are up to date on MMR vaccine and other recommended vaccines.
  • For people traveling abroad, CDC recommends that all U.S. residents older than 6 months be protected from measles and receive MMR vaccine, if needed, prior to departure.
  • To potentially provide protection or modify the clinical course of disease among susceptible people, either administer MMR vaccine within 72 hours of initial measles exposure, or immunoglobulin (IG) within six days of exposure. For vaccine eligible people aged ≥12 months exposed to measles, administration of MMR vaccine is preferable to using IG, if administered within 72 hours of initial exposure. 
  • The following patient groups are at risk for severe disease and complications from measles and should receive IG: infants aged <12 months, pregnant women without evidence of measles immunity, and severely immunocompromised people. IG can be administered to other people who do not have evidence of measles immunity, but priority should be given to people exposed in settings with intense, prolonged, close contact (e.g., household, daycare, and classroom). Do not administer MMR vaccine and IG simultaneously, as this practice invalidates the vaccine.


Categories of Health Alert Network messages:


Health Alert- provides vital, time-sensitive information for a specific incident or situation; warrants immediate action or attention by health officials, laboratorians, clinicians, and members of the public; and conveys the highest level of importance.


Health Advisory- provides important information for a specific incident or situation; contains recommendations or actionable items to be performed by public health officials, laboratorians, and/or clinicians; may not require immediate action.


Health Update- provides updated information regarding an incident or situation; unlikely to require immediate action.


HAN Info Service- provides general public health information; unlikely to require immediate action.


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