Below is an article published in R&R Magazine April 2015.
The Measles Virus has been the subject of significant national
attention lately, with 644 cases of measles reported to the Centers for
Disease Control in 2014. These cases represent the highest number since
the virtual elimination of measles in the United States following the
development of the vaccine. This is a significant increase when compared
to 2012 and 2013 with a total of 55 and 187 reported cases,
respectively. Measles is common and often fatal in developing countries,
but has been rare in the United States since the widespread vaccination
program in the early 1970s.
Measles is an acute highly contagious viral illness that i s transmitted between humans primarily through respiration of the measles virus (Morbillivirus). Following exposure, the virus replicates in the upper respiratory system, entering the bloodstream 2-3 days after exposure. The virus is spread to tissues within 5-7 days and after a 10-12 day period, clinical symptoms appear. Early symptoms include; cough, fever increasing to 103°F or higher, eye inflammation and white lesions within the mouth. Two to four days later, a rash begins on the face and head, spreads to the entire body and persists 5-6 days before fading in order of appearance. Other complications often include; inner ear inflammation, pneumonia, croup and diarrhea. Very rare complications can include: acute encephalitis (brain swelling), respiratory distress and neurologic complications, which can result in death. Rarer still is a fatal degenerative disease of the central nervous system that generally develops 7 to 10 years after the measles infection.
out of ten individuals not immune from a previous measles infection or
from vaccination can get measles when exposed to an infected person.
Measles is transmitted primarily person to person via large respiratory
droplets. Less commonly, it is transmitted by aerosolized droplets in
closed areas and less still by contact with contaminated environmental
surfaces. Measles may be transmitted between humans from 4 days before
to 4 days after rash onset. Maximum communicability occurs from onset of
early symptoms through the first 3–4 days of rash. There is no
treatment for measles that targets the infection. Treatments are
directed at taking care of the symptoms and complications from the
Vaccination is by far the best way to prevent measles. The vaccine is commonly referred to as the MMR vaccine (Measles, Mumps & Rubella). The triple vaccine has been available since the early 1970s and is considered safe by the worldwide medical community. All individuals are recommended to receive the vaccine with the exception of those allergic to its components or ones with severely compromised immune systems.
the routine infection control procedures followed by the medical
community is suitable for containment of the virus. Alternatively, for
the environmental cleaning professional there is a lack of specific
guidelines for disinfectant product usage for combatting the Measles
virus. This is due primarily to the existence of the vaccine making
measles exposure exceedingly rare in the United States, therefore it is
not found on EPA registered product organism lists. With the absence of
testing data the key to developing a sound disinfection program lies
within the morphology and epidemiology of the virus.
is an enveloped virus, meaning there is a lipid membrane encasing the
organism. Enveloped viruses are typically less hearty than
non-enveloped viruses (such as Rotavirus and Norovirus), because the
detergent and/or disinfectant must simply compromise the lipid membrane
in order to kill the organism. This makes enveloped viruses highly
susceptible to surface cleaning with detergents followed by application
of disinfectants. As is the case with all cleaning and disinfection
processes the initial surface cleaning is critical to the success of the
disinfection of a measles contaminated environment. Proper cleaning
removes the sputum along with other soils and organic debris from
surfaces, degrading the environment where organisms can thrive. In the
case of measles, patient’s frequent coughing and skin lesions make
environmental surface contamination likely, albeit for only a short
period. The measles virus remains viable on environmental surfaces for
only up to two hours, versus influenza viruses which can last 1-2 days.
This characteristic reduces the potential for exposure from
environmental surfaces greatly.
Based on the morphology of the organisms, a wide range of disinfectants are appropriate to combat the virus. These include: alcohols, hypochlorite solutions, hydrogen peroxide, peracetic acid, phenolics and quaternary ammonium compounds. When choosing a disinfectant look for products that are registered for enveloped viruses, common examples of which include influenza viruses and HIV. Ideally, a disinfectant containing a biostat should be used to inhibit the organisms from attaching to surfaces, further reducing the transmission potential. Proper application of disinfectants is critical to their success, so follow manufacturer guidelines carefully including mixing, application methods and dwell time. The cleaning and disinfection process should be completed routinely (minimum daily) in situations where an infected (or suspected) person is present. Ensure high touch surfaces such as, knobs and railings, and horizontal surfaces such as, table tops and floors are included in the cleaning and disinfection process.
key to measles prevention and potential eradication is vaccination. A
rate of ~92%, which is attainable in a static population, can result in
a 99% reduction of the disease. Unfortunately, as international travel
becomes commonplace and worldwide population migration continues,
vaccination rates in populations can vary to a point where this rates
drop to a level where outbreaks can occur. With the goal of worldwide
elimination seemingly far off, the need for proper infection control
becomes the second line of defense. Infection control is accomplished
through proper hygiene practices and a sound environmental cleaning
regiment in our institutions, health care settings and public areas.