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Ronald McDonald House: Measles Case Study · The SHEA Podcast

• 0:07
  SPEAKER_01: Welcome to the SHA podcast for Ronald McDonald House Charities.
• 0:12
  SPEAKER_01: This podcast series was created with the SHAPE Pediatric Epidemiologists and Antibiotic Stewards Group piece.
• 0:20
  SPEAKER_01: While this is specifically created for Ronald McDonald's House, the principles would apply for any resident care facility.
• 0:29
  SPEAKER_01: As of June 2025, the world is experiencing a significant resurgence of measles.
• 0:36
  SPEAKER_01: So maybe let's start with the facts.
• 0:38
  SPEAKER_01: The United States has documented 1,319 cases across 40 jurisdictions, marking the largest outbreak since 2020.
• 0:49
  SPEAKER_01: Texas is a major hotspot with three deaths reported nationwide.
• 0:54
  SPEAKER_01: In Europe, there were 17,940 confirmed cases over the last 12 months of reporting, the highest since 1997, and this is largely due to low vaccination coverage in countries like Ukraine as well as Romania.
• 1:12
  SPEAKER_01: Southeast Asia is also heavily affected, and Australia faces its worst outbreak since 2019.
• 1:19
  SPEAKER_01: And this is also attributed to the decreased vaccination rates.
• 1:24
  SPEAKER_01: Canada has over 3,878 confirmed cases reported nationwide.
• 1:31
  SPEAKER_01: And this is the highest number since the disease was declared to be eliminated in 1998.
• 1:39
  SPEAKER_01: The outbreak really started to spread in Ontario in late 2024 and has since spread to multiple provinces, including Alberta, Quebec, and British Columbia.
• 1:54
  SPEAKER_01: Worldwide, public health officials are urging individuals to ensure that they are fully vaccinated with the MMR vaccine, and that's especially before international travel to curb the spread of this highly contagious disease.
• 2:10
  SPEAKER_01: My name is Matthew Chader, and I'm the proud CEO of Ronald McDonald's House here in southwestern Ontario.
• 2:16
  SPEAKER_01: And I'm joined today by Dr.
• 2:18
  SPEAKER_01: Ayelet Rosenthal from Laurie Children's Hospital of Chicago, representing Shay's Peace Group.
• 2:25
  SPEAKER_01: Now, Dr.
• 2:25
  SPEAKER_01: Rosenthal, I'd like to start by saying that measles is on my mind and on my team's mind all the time.
• 2:35
  SPEAKER_01: I'm constantly thinking about how to protect everyone who comes to Ronald McDonald's House and how we can be proactive and vigilant in face of this outbreak.
• 2:46
  SPEAKER_01: And I know that we're not alone in this concern, and that is uh it's shared across Ronald McDonald's House chapters globally.
• 2:55
  SPEAKER_01: And what I'd really like to do today is to walk through a case study on what to do if someone infected with measles visited or stayed in a Ronald McDonald's house.
• 3:07
  SPEAKER_00: Thank you so much for having me.
• 3:08
  SPEAKER_00: I'm glad to be here and help work through this scenario and how to respond.
• 3:13
  SPEAKER_01: Thanks, Dr.
• 3:13
  SPEAKER_01: Rosenthal.
• 3:14
  SPEAKER_01: And now maybe just starting right from the beginning, how would we know if there is a measles case?
• 3:20
  SPEAKER_01: And what should we be on the lookout for?
• 3:23
  SPEAKER_00: There are a few ways that a person with suspected or confirmed measles will present at your facility.
• 3:29
  SPEAKER_00: Either they come and report that they have been tested positive for measles, or they report that they have been exposed to someone with measles, or a person that presents with measles symptoms.
• 3:41
  SPEAKER_00: The most common symptoms of measles are fever, high fever, and a body rash.
• 3:47
  SPEAKER_00: And the characteristic rash usually starts at the nape of the neck, the face, and then spreads down to the chest, abdomen, and extremities.
• 3:55
  SPEAKER_00: But before developing the thrash, there is a period of nonspecific symptoms, usually with fever, cold-like symptoms, some running nose, and sometimes red eyes.
• 4:05
  SPEAKER_00: And at that period, it's difficult to diagnose or identify measles.
• 4:10
  SPEAKER_00: So you need to be on the lookout for guests who present with concerning symptoms and mention that they did not receive the MMR vaccine, either verbally or in your screening tool if you have one.
• 4:23
  SPEAKER_01: Okay, great.
• 4:25
  SPEAKER_01: And so we we think we may have a suspected case.
• 4:30
  SPEAKER_01: What would our first action be from that point?
• 4:33
  SPEAKER_01: Would it be notifying public health officials?
• 4:36
  SPEAKER_01: And what should we ask the family or the person who has that suspected or confirmed case of measles to?
• 4:44
  SPEAKER_00: Your goal is to minimize the risk of transmission in the facility.
• 4:48
  SPEAKER_00: Children with suspected measles and their family members should be restricted from the family-centered residential facility.
• 4:55
  SPEAKER_00: I would recommend that the child will go to get a medical evaluation or maybe get tested, but please notify the healthcare facility that you're sending a child with suspected measles because they will need to prepare themselves.
• 5:07
  SPEAKER_00: And most importantly, contact your local health agency for further instructions.
• 5:14
  SPEAKER_01: Okay, great.
• 5:14
  SPEAKER_01: And who would notify the guest families who may have been exposed?
• 5:20
  SPEAKER_01: Would that be something that we notify them of, or would it be public health officials or maybe both?
• 5:28
  SPEAKER_00: The Department of Health will guide you through the process of notifying the exposed guests.
• 5:32
  SPEAKER_00: They will probably ask you for a list of possibly exposed individuals and for other information if it is available.
• 5:40
  SPEAKER_00: And they will contact them for further guidance and if they need post-exposure prophylaxis.
• 5:45
  SPEAKER_00: You will also want to notify your partner hospital of the exposure because they might be the place that the post-exposure prophylaxis is being given.
• 5:54
  SPEAKER_01: And if we get any questions around advice or unvaccinated close contacts, what would you advise us in saying?
• 6:05
  SPEAKER_00: Since you are not providing medical care to your guests, you would not be able to give advice for unvaccinated guests.
• 6:12
  SPEAKER_00: So when you speak with the public health officials, just make sure to explain your role and responsibilities to them and ask them for guidance.
• 6:21
  SPEAKER_01: This is all very, very helpful.
• 6:24
  SPEAKER_01: During the recent COVID-19 pandemic, across this system for Ronald McDonald's house, we used strategies like isolation and quarantine practices to prevent the spread of infection.
• 6:37
  SPEAKER_01: So thinking today, how might these strategies apply to a possible measles case in one of our house facilities?
• 6:46
  SPEAKER_01: We also required our guest families, staff, and volunteers to wear masks in all communal spaces in the house.
• 6:54
  SPEAKER_01: And how effective would this be to reduce the spread of measles in the house?
• 6:59
  SPEAKER_01: And is there any other PPE that we should be aware of?
• 7:07
  SPEAKER_00: Measles is more contagious than COVID-19.
• 7:10
  SPEAKER_00: It does spread through air and it can linger in a room for two hours after someone leaves it with suspected measles.
• 7:18
  SPEAKER_00: So while isolation and quarantine are still very important tools, they need to be applied quickly and they only minimize, but they do not eliminate the risk of transmission.
• 7:29
  SPEAKER_00: If there is a suspected measles case in the facility, that person should be actually relocated because the facilities don't have the kind of airborne isolation that is needed for measles.
• 7:41
  SPEAKER_00: Right.
• 7:41
  SPEAKER_01: And along these same lines, what would be the kind of cleaning we should do across Ronald McDonald's house and maybe in the room specific that the family might have been staying in or potentially visited?
• 7:55
  SPEAKER_00: You should use a disinfectant that is approved by the relevant national or regional health authority.
• 8:02
  SPEAKER_00: And if this is not available to you, then diluted bleach solution that can be used to clean surfaces in the room.
• 8:11
  SPEAKER_00: In addition, it is important not to allow guests into this room for two hours after a person with suspected measles have left that room.
• 8:20
  SPEAKER_01: And is there anything that you think that we should be aware of at this point or as we continue to really uh reflect and prepare on these practices across our system?
• 8:34
  SPEAKER_00: Can't stress this enough.
• 8:36
  SPEAKER_00: The best way to prevent measles is to be protected from the virus, and it's through vaccination.
• 8:41
  SPEAKER_00: We know that the vaccines work and they're highly effective.
• 8:46
  SPEAKER_00: Continue to screen for measles vaccine if you can, and continue to encourage your guests, employees, and volunteers to get vaccinated.
• 8:56
  SPEAKER_01: Well, thank you so much, Dr.
• 8:57
  SPEAKER_01: Rosenthal, for this really informative conversation.
• 9:01
  SPEAKER_01: I know that I'm taking a lot away from what you've shared.
• 9:05
  SPEAKER_01: And I appreciate your time to uh to respond to all of these questions, as I'm I'm sure they're they're top of mind for many uh out there today.
• 9:14
  SPEAKER_01: And so just as a reminder for those listening, uh Shay worked closely with Ronald McDonald House charities to update our infection prevention and control documents, and that every house should review these documents periodically, and especially if there is an infectious disease outbreak in your area.
• 9:33
  SPEAKER_00: Thank you so much for having me here.
• 9:35
  SPEAKER_00: The resurgence of measles has been challenging across facilities, but I am very much encouraged that Ronald McDonald is being so proactive.
• 9:45
  SPEAKER_01: Thank you again.