Measles Alert

 

Brooklyn finds itself as a center of activity with the ongoing outbreak of measles. For those of our membership practicing in the affected areas where the outbreak has hit, Second District would like to bring the following up-to-date information and advice to you from the NYC Health Department.

 

According to the NYC Health Department alert published 4/24/19: A total of 390 individuals with measles have been confirmed since October in New York City as part of this outbreak. Nearly all of these cases have occurred among persons living in Williamsburg and Borough Park. A small number of cases have occurred outside of these neighborhoods but have, to date, not resulted in sustained transmission of measles. Specifically, "all but twelve of these individuals with measles are members of the Orthodox Jewish communities of Williamsburg (323, 83%) and Borough Park (55, 14%). A small number of cases have occurred outside of the Williamsburg and Borough Park neighborhoods at the core of the current outbreak. These cases have been diagnosed in residents of Midwood/Marine Park (4), Brighton Beach (2), Flushing (2), Crown Heights (1), Bensonhurst (1), Far Rockaway (1) and the Hunts Point, Longwood and Melrose section of the Bronx (1)."

 

While most of the Health Department alerts are instructional to your physician colleagues practicing in the affected areas, we have asked for some advice specifically meant for the dental community. Our thanks to Dr. Mary Foote, MD, MPH who is the Senior Medical Coordinator for Communicable Disease Preparedness for sharing the following advice as it applies to you, your staff and patients:

 

Hi Bernard, nice speaking with you today. Just to summarize, here are some recommendations you can give to your partners:

  1. Make sure you and your staff are protected by assessing their immunity (including contractors) and ensure that everyone has documentation of 2 MMRs or + IgG titers. If you do not have this on record, they should receive an MMR. Detailed information on vaccine recommendations for healthcare staff can be found here: https://www.cdc.gov/mmwr/pdf/rr/rr6007.pdf

  2. Educate your staff on the symptoms of measles so they know how to recognize it. The symptoms include: fever + rash + any of the “3 Cs” (cough, coryza [runny nose], conjunctivitis). Photos of measles rashes can be found here: https://www.cdc.gov/measles/about/photos.html 

  3. Post signage warning patients with possible measles symptoms to inform the clinic staff before entering. Example posters and other resources are on our measles provider page: https://www1.nyc.gov/site/doh/providers/health-topics/measles.page

  4. If a patient reports signs or symptoms compatible with measles, they should ideally be rescheduled for the end of the day. If that is not possible, they should be given a mask before entering and escorted directly to a private room, preferably through a separate entrance that avoids the waiting room.

  5. It is appropriate to implement phone screening if your facility is in or near one of the affected neighborhoods/zip codes. If a patient is reporting fever + rash + any of the “3 Cs” (cough, coryza, conjunctivitis), the patient should not come in unless there is a dental emergency). They can be referred to a medical clinic if they need medical care but should call ahead to alert the clinic of the symptoms before they arrive to ensure appropriate infection control measures are taken.

  6. If a provider is seeing a patient with fever and rash, or fever and upper respiratory symptoms (from an at risk zip code or with known measles exposure), the patient should be given a surgical mask and isolated in a private room with the door closed and the room should remain empty for 2 hours after patient leaves. The dental provider should also be wearing a mask (N95 if available, otherwise surgical mask) in the room with any patient suspected of having measles.

  7. Please report any suspect case to the NYC Department of Health and Mental Hygiene by calling our provider access line at (866) 692-3641.

 

It goes without saying that ALL offices should continually utilize universal infection control precautions including proper sterilization and personal protective wear. Signage from the Heath Department for your office is readily downloadable from the City’s website. Let your patients know that if they have been exposed or are symptomatic, non-emergent dental treatment should be rescheduled until after medical clearance has be given. Persons suspected to have measles should be reported immediately to the Health Department at 866-692-3641.

 

Please feel free to consult the NY City Health Department for any further alerts concerning the measles outbreak. Their website is updated frequently.

 

https://www1.nyc.gov/site/doh/providers/health-topics/measles.page