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How to tell if an inmate has measles

Do you know the signs and symptoms of measles so you can contact the medical unit and avert a major outbreak in your facility?


In my last column, I talked about measles myths, screening, and vaccination. What if an inmate enters your facility and has already been infected? Do you know the signs and symptoms of measles so you can contact the medical unit and avert a major outbreak in your facility?

What does measles look like?

Measles (also called rubeola) is a viral infection of the upper respiratory tract. It eventually causes a rash that starts at the hairline and slowly works down the rest of the body.  A few days before the rash appears, the person seems to have a bad cold or the flu. The starting symptoms of this virus are:

  • Cough
  • Runny nose
  • Red, teary eyes
  • Fever

Before the rash begins appearing at the hairline and on the face, tiny spots develop on the inside of the mouth. Of course, unless the person mentions it, you are unlikely to catch that sign. However, a suspicious rash that started on the face of an individual who has cold/flu symptoms should get an medical evaluation as soon as possible. Don’t have the inmate put in a kite for a medical visit. In fact, if an inmate has cold symptoms that include red, teary eyes, don’t wait for that rash to appear, get them checked out by medical.

Since this virus is highly contagious, it is advisable to put a respiratory mask on the person to contain any viral spread while moving them to the medical unit for evaluation. These CDC guidelines for managing potential measles in an airplane cabin have application in the correctional setting.

How is measles spread?

Measles is a virus with no treatment; however, those who have had it before or have been vaccinated have immunity and will not contract the infection. Those without immunity can easily contract the condition through contact with virus-filled mucus from the cough or runny nose of someone with the infection, or from using the same drinking glasses or eating utensils. According to the CDC, the virus can live for up to two hours on a surface or in an airspace where the infected person coughed or sneezed. A person who has contracted measles will be contagious up to four days before a rash appears and up to four days after the rash appears. This virus is so contagious that 90 percent of those around a person with the condition will be infected if they have no immunity.

What to do about measles

A correctional facility is prone to rapid infection spread. The close living quarters of individuals with limited hygiene opportunities and generally poor understanding of infection prevention is a breeding ground for communicable diseases.

  • Keep alert for all indications of spreading infection. If you are in a geographic region where a measles outbreak is present, be particularly vigilant for the signs of measles listed above and send inmates for medical evaluation with any concern.
  • Talk to medical about providing inmates with some added infection prevention patient education during this vulnerable period for measles transmission.
  • Since the measles virus can live on surfaces for up to two hours, consider increased cleaning of housing common areas during at-risk periods.
  • If you are in a management position, consider how an outbreak might be handled in your system. For example, where would inmates go once your isolation cells were maxed out? Are there collaborative agreements with neighboring facilities to handle your overflow?

Are you prepared for a measles or other infectious disease outbreak in your facility? Share your process in the comments section of this post.

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