OHCP Exposed to or Infected with Measles, Mumps, and Rubella

The measles, mumps, rubella viruses and the novel SARS-CoV-2 are spread primarily by droplets and droplet nuclei generated by an infected person during talking, breathing, coughing, and sneezing; by direct contact with nasal or throat secretions; and less frequently by touching freshly contaminated articles and environmental surfaces.^2,44-46 In oral healthcare settings, administrative policies and work restrictions are primarily predicated on the mode of transmission of these pathogens and the period of infectivity of exposed or infected OHCP (Table 6).^1,2

Table 6. Work Restrictions: Measles, Mumps, and Rubella Infections.^1,2

Infectious State		Restrictions
Measles	Susceptible OHCP Post-exposure	Exclude from duty From the 5^th day after first exposure through the 21^st day after last exposure OR For 4 days after rash appears
Measles	OHCP with acute infection	Exclude from duty For 7 days after rash appears
Mumps	Susceptible OHCP Post-exposure	Exclude from duty From the 12^th day after first exposure through the 26^th day after last exposure OR For 5 days after onset of parotitis
Mumps	OHCP with acute infection	Exclude from duty For 5 days after onset of parotitis (2017 update)
Rubella	Susceptible OHCP Post-exposure	Exclude from duty From the 7^th day after first exposure through the 21^st day after last exposure
Rubella	OHCP with acute infection	Exclude from duty For 7 days after rash appears

The SARS-CoV-2 (COVID-19) pandemic was declared over on May 11, 2023⁴⁷ and the infection-related isolation / return to work guidelines for the public were substantially modified (relaxed) on March 1, 2024.⁴⁸ However, the more restrictive guidance (last updated on September 23, 2022) addressing SARS-CoV-2 infection and return to work guidelines in the healthcare setting remain in effect and are briefly summarized in Table 7.

Table 7. Work Restrictions: SARS-CoV-2.⁴⁹

Infectious State

Restrictions

SARS-CoV-2

OHCP with
potential exposure*

Asymptomatic OHCP do not require work restrictions
Self-monitor for fever (>100°) or symptoms
consistent with COVID-19
Medical evaluation as needed

OHCP with confirmed
infection

For OHCP who are not severely immunocompromised and who were asymptomatic throughout their infection may return to work when at least 7 days have passed since the date of their first positive viral diagnostic test.
OHCP with mild to moderate illness who are not severely immunocompromised, exclude from work until:
- At least 7 days have passed since symptoms first appeared and
- At least 24 hours have passed since last fever without the use of fever-reducing medications and
- Symptoms (e.g., cough, shortness of breath) have improved

OHCP with severe to critical illness or who are severely immunocompromised, exclude from work until:
- At least 10 and up to 20 days have passed since
  symptoms first appeared and
- At least 24 hours have passed since last fever without the use of fever-reducing medications and
- Symptoms (e.g., cough, shortness of breath) have improved
- Consider consultation with infection control expert

Note: OHCP who are moderately to severely immunocompromised may produce replication-competent virus beyond 20 days after symptom onset or, for those who were asymptomatic throughout their infection, the date of their first positive viral test. Consultation with infectious diseases specialists is recommended. Use of a test-based strategy for determining when these HCP may return to work could be considered.

* Risk criteria for potential exposure:

Prolonged close contact (>15 minutes) with a patient, visitor, or HCP with confirmed SARS-CoV-2 infection and

OHCP not wearing a respirator or facemask
OHCP not wearing eye protection if the person with SARS-CoV-2 infection was not wearing a cloth face covering or facemask.
OHCP not wearing all recommended PPE (i.e., gown, gloves, eye protection, respirator) while performing an aerosol-generating procedure.

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