What You Need To Know
Key messages:
- A laboratory confirmed case of measles has been identified in a Hudson County resident. The individual was unvaccinated and the source of infection is unknown at this time. The Hudson County case is unrelated to the Ocean County measles case reported last week.
- Providers should remain vigilant and consider measles in people with a febrile rash illness lasting three days or more, a fever of 101°F (38.3°C) or higher, and clinically compatible symptoms (cough, coryza and/or conjunctivitis), particularly if the person was potentially exposed to a case of measles or has recently traveled internationally.
- Providers who are ordering measles testing should obtain samples from the following sites: oropharyngeal/nasopharyngeal swab (rRT-PCR), urine (rRT-PCR), and serum (measles IgM and IgG).
- Providers should implement measles prevention measures by ensuring they and their staff are up-to-date with immunizations, triage patients by telephone, isolate patients upon arrival and have access to and are trained to use appropriate personal protective equipment (PPE) when interacting with patients.
- Providers should ensure their patients are up to date on recommended immunizations including MMR.
- Prior to international travel, everyone 6 months and older may be eligible for MMR.
- Measles is an IMMEDIATELY reportable condition, and providers should immediately report suspected cases of measles to local public health authorities where the patient resides, or if not available, to the NJDOH at (609) 826-5964 during regular business hours or (609) 392-2020 after business hours or on the weekend.
Background:
The New Jersey Department of Health (NJDOH) Communicable Disease Service would like to make you aware of a new confirmed measles case identified in a New Jersey (NJ) resident following.
The unvaccinated Hudson County resident developed rash on July 8 and was subsequently confirmed to have measles via positive measles PCR results. While infectious, the individual visited multiple health care facilities and public places. Anyone who visited the following locations, only during the dates and times listed, may have been exposed to measles:
- University Hospital, Pediatric Emergency Department, 150 Bergen St, Newark, NJ 07103
- Date & Time: July 4, 2025, between 5:30 PM and 10:15 PM
- Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ 07601
- Pediatric Emergency Department
- Date & Time: July 4, 2025, 11:15 PM through July 5, 2025, 2:30 AM
- Date & Time: July 8, 2025, between 12:45 AM and 7:15 AM
- Joseph M. Sanzari Children's Hospital
- Date & Time: July 8, 2025, 5:15 AM through July 9, 2025, 4:30 PM
- Pediatric Emergency Department
- Roast’d Coffee – Jersey City, 10 River Dr S, Jersey City, NJ 07310
- Date & Time: July 6, 2025, between 4:00 PM and 7:00 PM
- Newport Mall, 30 Mall Dr W, Jersey City, NJ 07310
- Date & Time: July 6, 2025, between 6:00 PM and 9:00 PM
- Al-Basha, 1076 Main St, Paterson, NJ 07503
- Date & Time: July 6, 2025, between 8:00 PM and 11:00 PM
- Elite Pediatrics, 1 Broadway, Suite 303, Elmwood Park, NJ 07407
- Date & Time: July 7, 2025, between 10:00 AM and 1:45 PM
- CVS, 220 Schuyler Ave, Kearny, NJ 07032
- Date & Time: July 7, 2025, between 12:30 PM and 3:00 PM
The NJDOH is working in collaboration with local health officials to identify and notify people who might have been exposed during the time the individual was infectious. Exposed individuals, if infected, could develop symptoms as late as August 2, 2025.
Therefore, the NJDOH requests healthcare providers maintain vigilance for measles among patients who meet the clinical criterion for measles (generalized maculopapular rash lasting 3 or more days, fever at least 101°F (38.3°C), and cough, coryza, or conjunctivitis). Take a detailed history to determine the individual’s travel history, contact with travelers or other possible exposures, vaccination status, and detailed history of present illness including symptoms, symptom onset dates and rash progression. Report all patients that are suspected of having measles IMMEDIATELY to local health department where the patient resides or, if not available, to the NJDOH.
Measles Specimen Collection and Testing
The NJDOH advises healthcare providers to collect specimens from patients suspected of having measles as early as possible in the course of illness. Efforts should be made to obtain specimens from suspected cases at first contact and testing should be expedited and coordinated with the local health department.
When there is a high index of suspicion, measles PCR testing is the preferred testing methodology, which is performed at the NJDOH Public Health and Environmental Laboratory. Approval is required by NJDOH prior to submission.
The following specimens should be obtained:
- Nasopharyngeal (NP) or throat swab for PCR testing - preferred (hold for NJDOH submission approval)
- Serum for measles IgM and IgG testing (send to commercial laboratory)
- Acute phase serum assoon as possible and convalescent serum 2-3 weeks later
- Collect minimum of 2 ml of blood in a red top or serum separator tube (red-speckled or gold).
- PLEASE NOTE:
- If serology is being ordered to determine measles immunity, commercial IgG testing is recommended. Do NOT order measles IgM if the patient is asymptomatic or recently vaccinated with MMR.
- Serologic test results should be interpreted with caution, as false-positive and false- negative results are possible with IgM tests.
- Urine specimens should only be collected if an NP or throat swab is not able to be collected.
Please see the NJDOH Quick Guide for Measles Specimen Collection and Testing and Measles Laboratory
Healthcare Providers:
- Ensure all patients without other evidence of immunity, especially those planning international travel, are up to date on MMR vaccine per routine ACIP recommendations.
- Providers who administer vaccines are strongly encouraged to become New Jersey Immunization
- System (NJIIS) users and submit administration data. By using NJIIS for all patients, regardless of age, it allows for a single source of documentation for all immunizations administered.
- Utilize NJIIS reminder/recall function to identify children needing MMR vaccination
- Empower patients by informing them if they have a vaccination record in NJIIS, it will then also be accessible to them for downloading through the Docket app (available for free download via Apple App Store or on Google Play).
- Establish documented evidence of immunity to measles now for all providers/staff and ensure access to status should an exposure occur.
- Implement screening/triage procedures: triage by telephone; post signage outside of the office notifying patients with rash to call BEFORE entering; mask and isolate (preferably in an airborne isolation room, if one is available) patients presenting with rash and fever immediately upon arrival; do not use exam room for at least 2 hours after a suspect measles leaves.
- Implement measles prevention measures
- Use a fit tested NIOSH-approved N95 or higher-level respirator.
- Remind providers/staff about the importance of using appropriate precautions.
- Ensure providers/staff have access to and are trained to use appropriate personal protective equipment (PPE) when interacting with patients.
- Review guidelines for post-exposure prophylaxis and identify points of access for persons needing MMR or immune globulin
- DO NOT refer persons exposed to measles, or suspected of having measles, to any medical facility WITHOUT calling and making arrangements first. Special arrangements must be made for evaluation and/or measles testing to protect other patients and medical staff from possible infection.
- Measles is an IMMEDIATELY reportable condition and providers should immediately report suspected cases of measles to local public health authorities where the patient resides or, if not available, to the NJDOH at (609) 826-5964 during regular business hours or (609) 392-2020 after business hours or on the weekend.