Measles in the ED: Early Recognition, Rapid Response, and Containment

A 4-year-old child presents to your emergency department with fever, cough, and conjunctivitis. The parent mentions they just returned from international travel. You notice a diffuse rash developing and what looks like tiny white spots on the child’s buccal mucosa. The child is sitting in your waiting room with a dozen other patients. Would you recognize measles—and know what to do next?

Measles, once considered eliminated in the United States, is making a comeback. With rising case numbers fueled by global travel and vaccine hesitancy, emergency physicians are increasingly likely to encounter this highly contagious virus—and must be ready to act fast.
This session will provide an essential update on measles tailored to emergency medicine physicians. We'll begin with an overview of recent epidemiologic trends and outbreaks, followed by a focused review of how measles presents in both typical and atypical forms. Participants will learn the key diagnostic clues—including the classic prodrome, enanthem (Koplik spots), and exanthem—as well as the timing of infectivity that makes early recognition critical.

We’ll discuss exactly what to do when you suspect measles in your ED: from placing patients under airborne precautions to coordinating testing with public health authorities. You'll learn how to properly collect diagnostic samples, which labs to order, and what to do when results are pending. We'll also cover indications for post-exposure prophylaxis, discharge criteria, and when admission or isolation is warranted.

By the end of this session, you’ll be equipped with the knowledge to recognize measles early, respond effectively, and protect your patients, colleagues, and community from this preventable disease. In a time when a single missed case can lead to widespread transmission, being prepared isn’t optional—it’s essential.