October 11, 2026
The Allegheny County Medical Society is sharing the following clinical guidance from Jillian Irwin, MD, Deputy Medical Director of the Allegheny County Health Department (ACHD), to help physicians identify suspected measles cases, coordinate reporting and testing, and review patients’ MMR vaccination status.
Printable Physician Handout
Download a two-page, print-friendly reference with clinical response steps, MMR vaccination recommendations, and ACHD contact information.
Download and Print the Physician Handout (PDF)
Recent Measles Activity
ACHD recently identified two cases of measles among county residents. Both patients are unvaccinated minors. The ACHD Public Health Laboratory also detected measles RNA in untreated wastewater collected on October 4, 2026, from a wastewater treatment plant in Allegheny County.
Physicians should maintain a high index of suspicion for measles in patients presenting with fever and rash, particularly those who are unvaccinated or have an unknown vaccination history. Obtain a history of potential exposures, contact with anyone known to have measles, recent travel, and MMR vaccination.
If Measles Is Suspected
1. Isolate Immediately
Instruct patients to call ahead before arriving so your team can arrange evaluation without exposing others. Do not allow patients with suspected measles to remain in waiting rooms or other common areas.
Mask the patient, if tolerated, and implement standard and airborne precautions. Place the patient in an airborne infection isolation room when available. If one is unavailable, use a private room with the door closed while arranging appropriate transfer.
Staff entering the room should wear a fit-tested N95 respirator or higher-level respiratory protection, regardless of immunity status. Notify your facility’s infection prevention personnel.
2. Report Immediately
Call ACHD at 412-687-2243 and ask to speak with Infectious Disease Epidemiology.
For suspected cases, do not wait for laboratory confirmation to contact ACHD, even if testing is available in-house.
3. Coordinate Testing with ACHD
Collect a nasopharyngeal swab and urine for measles rRT-PCR testing, along with serum for measles serology.
ACHD staff can provide specimen collection and submission instructions and coordinate testing through the Public Health Laboratory if indicated.
MMR Vaccination Recommendations
Use patient encounters to review MMR vaccination records and offer vaccination when indicated.
The following ACHD guidance for adjustments to the MMR vaccination schedule in Allegheny County is concordant with recommendations from the Pennsylvania Department of Health for counties with community transmission of measles (see PA HAN 831).
Infants Ages 6–11 Months
An early MMR dose is recommended by ACHD for infants. This supplementary “dose zero” does not count toward the routine two-dose series.
Infants vaccinated before their first birthday must receive two additional doses, at least 28 days apart, after turning 12 months.
Children Ages 12 Months Through 6 Years
Unvaccinated children should receive their first MMR dose now. The second dose may be administered at least 28 days later rather than waiting until age 4–6 years.
Children with one valid prior dose may receive their second dose now if at least 28 days have elapsed.
Two valid doses administered at age 12 months or older complete the routine MMR series; another dose is not needed for kindergarten entry.
School-Aged Children and Adolescents
Those without other acceptable evidence of immunity should have two documented, valid MMR doses.
Give a second dose to those with only one valid dose once at least 28 days have elapsed. Those who are unvaccinated should receive two doses at least 28 days apart.
Adults
Review documented vaccination and other acceptable evidence of immunity. Under this ACHD guidance, adults should have two documented MMR doses or other acceptable evidence of immunity.
Those with one valid dose should receive a second at least 28 days later. Those who are unvaccinated should receive two doses at least 28 days apart.
Adults born before 1957 are generally considered immune. However, health care workers born before 1957 without laboratory evidence of immunity or disease should consider vaccination with a two-dose series separated by at least 28 days.
Adults who received only the inactivated (killed) measles vaccine available from 1963–1967 should be considered unvaccinated and revaccinated with a total of two post-1967 MMR doses.
Vaccination Access for Uninsured Patients
MMR vaccination is available at no cost to uninsured patients at the ACHD Immunization Clinic, 425 First Avenue, downtown Pittsburgh.
Appointments can be scheduled through MyChart or by calling 412-578-8062.
Clinical Questions
For clinical questions, call 412-687-2243 and ask to speak with ACHD Infectious Disease Epidemiology.
ACHD thanks physicians for their vigilance and partnership in protecting our community.
Download and print the physician handout to keep this guidance available in your practice.