Epi Report: Measles Updates for Clinicians cont.
Year 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Dallas County 0 0 0 0 0 0 2 1 0 0 1
Collin County 0 0 0 0 0 0 0 2 0 0 0
Denton County 0 0 0 0 0 0 7 0 0 0 0
Tarrant County 0 0 0 0 3 0 16 1 1 0 0
Texas 7 0 1 0 6 0 27 10 1 1 1
Table 1. Number of Measles Cases by County, Dallas-Fort Worth Area and Texas: 2007–2017
Figure'4. Measles.containing.vaccine'(MCV)'Vaccination'(≥1'dose)'Rate'in'Children'Ages'12.23'Months'vs.'Overall'Incidence'Rate'for'Measles,'United'States:'1980.2017*
Figure 4. Measles-containing-vaccine (MCV) Vaccination (≥1 dose) Rate in Children
*Source:'Incidence'Rate. 1980.2015'from'CDC'MMWR:'Summary'of'Notifiable'Diseases'(https://www.cdc.gov/mmwr/mmwr_nd/index.html)'and'2016.2017'from'CDC'National'Notifiable'Infectious'Diseases'and'Conditions'(https://wonder.cdc.gov/nndss/nndss_annual_tables_menu.asp),''Vaccination'Rate'
Ages from'World'Bank/12–WHO'(23 https://Months data.worldbank.org/indicator/vs.SH.Overall IMM.MEAS)
Incidence Rate for Measles, United States: 1980–2017*
*Source: Incidence Rate:1980–2015 from CDC MMWR: Summary of Notifiable Diseases (cdc.gov/mmwr/mmwr_nd/index.html) and 2016–2017 from CDC National
Notifiable Infectious Diseases and Conditions (wonder.cdc.gov/nndss/nndss_annual_tables_menu.asp),Vaccination Rate from World Bank/WHO
(data.worldbank.org/indicator/SH.IMM.MEAS)
Specimen collection and laboratory diagnosis
At first contact with the patient, a throat (or nasopharyngeal) swab and blood specimen should be collected from a patient with clinical
features of measles. A nasopharyngeal swab is the preferred specimen for measles PCR detection or viral culture. The swab should be
collected as soon as possible and not more than 10 days after rash onset. Serologic testing for measles IgM antibodies also should be
performed as soon as possible after symptom onset. Because IgM may not yet be detectable in some specimens obtained within the first
72 hours after rash onset, a second serum specimen should be collected, if clinically indicated, ≥72 hours after rash onset if the initial IgM
test was negative. Vaccinated persons may not have detectable IgM, regardless of timing of collection.6,8 IgG testing primarily is useful as
evidence of prior measles immunity in asymptomatic close contacts of measles cases.8
12 Dallas Medical Journal December 2018