OHCP Exposed to or Infected with Measles, Mumps, Rubella, and SARS-CoV-2

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.^47-50 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 and (Table 7).^51,52

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 9 days after onset of parotitis
Mumps	OHCP with acute infection	Exclude from duty For 7 days after onset of parotitis
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 5 days after rash appears

Table 7. Work Restrictions: SARS-CoV-2.^51,52

Infectious State

Restrictions

SARS-CoV-2

OHCP with
potential exposure*

Exclude from duty for 14 days after last exposure
Self-monitor for fever (>100°) or symptoms
consistent with COVID-19
Medical evaluation as needed

OHCP with confirmed
infection

OHCP with mild to moderate illness who are not
severely immunocompromised, exclude from work until:

At least 10 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

Note: For OHCP who are not severely immunocompromised and who were asymptomatic throughout their infection may return to work when at least 10 days have passed since the date of their first positive viral diagnostic test.

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 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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