Postexposure Evaluation and Follow-up
Healthcare-associated Exposure to Measles, Mumps, or Rubella Viruses

If measles, mumps, or rubella exposure occurs in a healthcare setting, all case-patient contacts should be evaluated immediately for presumptive evidence of measles, mumps, or rubella immunity.^9-11 Persons are considered immune only if they have documentation of:

1. physician-diagnosed measles, mumps, or rubella infection
   
   or
2. laboratory evidence of measles, mumps, or rubella immunity
   
   or
3. appropriate vaccination against measles, mumps, and rubella
   
   or
4. birth before 1957.

Measles
The measles virus is transmitted from person-to-person primarily by direct contact with respiratory secretions or by inhalation of airborne droplets generated by coughing or sneezing. Exposed HCP without evidence of immunity to the measles virus should be offered the MMR vaccine and an intramuscular dose of immune globulin (IG).¹² Available data suggests that the live measles vaccine, if administered within 72 hours of exposure, will prevent or modify the disease. Exposed HCP should be closely monitored for sign(s) of illness.

Mumps
The mumps virus is transmitted from person-to-person primarily by direct contact with saliva or by inhalation of airborne droplets generated by coughing or sneezing. Exposed HCP without evidence of immunity to the mumps virus should be offered the MMR vaccine.¹² However, antibodies develop slowly to the mumps component of the vaccine to provide effective prophylaxis after exposure and IG is not routinely recommended for postexposure prophylaxis for mumps. Exposed HCP should be closely monitored for sign(s) of illness.

Rubella (German measles)
The rubella virus is transmitted from person-to-person primarily by direct contact with respiratory secretions or by inhalation of airborne droplets generated by coughing or sneezing. There is no evidence that postexposure vaccination is effective in preventing rubella infection. IG administered within 72 hours of exposure might reduce the risk (infants with congenital rubella have been born to women who received IG shortly after exposure).¹² Exposed HCP should be closely monitored for sign(s) of illness.