Measles FAQ

We have compiled a list of questions and answers based on commonly asked questions we have received in response to the May 2019 presumptive positive case of the measles in Alabama. For more information about measles, see the What's New section of Immunization.

Question 1

Why was there a delay in ADPH reporting any test results when social media reported a positive measles case 2-3 days prior to ADPH press conference? Why was this initially called confirmed and then later ADPH changed it to presumptive?

Answer 1: ADPH did not receive any information related to a suspected measles case until the IgM results were received electronically at 8:02am on Thursday, May 2. The signs and symptoms, test results and initial information met the CDC’s case definition which is used by Alabama and other states to determine case status. The initial, early investigation indicated that the definition requirements were met. Due to the highly infectious nature of measles, it was decided to make the public aware providing what we knew as soon as we knew it due to calls and emails already generated by the reports on social media. Understanding that measles IgM false positives are not uncommon and that the infant did not have contact with a measles case, ADPH changed from “confirmed” case to “presumptive” case while awaiting additional testing. ADPH continues to work to get the additional testing needed to determine whether this is a case or is not a case. The additional testing is performed by the Wisconsin Public Health Laboratory and the Centers for Disease Control and Prevention (CDC).

05/10/19 Update: Results of additional testing performed by the CDC were negative. This mean that the unvaccinated infant in St. Clair County will be classified as not a case of measles following multiple negative tests. Initial test results reported as presumptive positive were performed by an out of state commercial laboratory, and not at the Bureau of Clinical Laboratories or at the CDC.

Question 2

When will ADPH know if genotype testing will occur?

Answer 2: ADPH asked for clarification from the CDC and received clarification on Thursday, May 9 that genotyping cannot be confirmed if PCR testing is negative even in the presence of a positive IgM. ADPH is awaiting additional test results.

05/10/19 Update: With final test results reported as negative by the CDC on Friday, May 10, no additional testing will be performed.

Question 3

When will ADPH report the results of confirmatory testing performed by the CDC?

Answer 3: Since the original testing on the specimen was performed by an out of state commercial laboratory, ADPH has experienced delays in getting the original specimen shipped. The initial test performed by the commercial laboratory was an IgM. The delay in shipping and receipt has resulted in an unexpected delay in getting the additional testing performed by the CDC. ADPH is working to expedite shipping and will report results as soon as they are available. CDC will be performing IgM testing using methodology with a higher specificity which will hopefully definitively answer question as to whether positive or negative. Additional specimens may still be required if the results are indeterminate to establish the final case status as to whether a case or not a case.

05/10/19 Update: The results were reported by the CDC on Friday, May 10. PCR, IgM, and IgG were all negative.

Question 4

An earlier response to a question says that persons with immune deficiency and weakened immune systems should not receive the MMR. What does this mean?

Answer 4: Persons whose immune systems are too weak to develop immunity should not take the MMR vaccine because it is a live virus. Persons with compromised or weakened immune systems include people undergoing chemotherapy, people with AIDS, people with chronic diseases of the immune system and people with allergy to the vaccine components. In addition, persons with acute, moderate to severe febrile illnesses are also told to delay vaccination until well.