Healthcare Provider Memo: Measles detection in wastewater

Healthcare Provider Memo: Measles detection in wastewater

Dear colleagues,

We are writing to inform you that measles was detected during routine untreated wastewater (sewage) surveillance in the Louisville Metro area on multiple days between July 6 – July 14. While no measles cases have been reported to public health officials, this detection in wastewater means there was at least one person with an undiagnosed or unreported measles infection present in the area around the time of this detection. At this time, we encourage healthcare providers to maintain an increased index of suspicion and consider the diagnosis of measles in patients with a fever and a rash, particularly those without documented immunity to measles or who may have possible exposures.

Take steps to prevent the transmission of measles:

When measles is suspected, provide the patient with well-fitting surgical mask and place them in a room immediately.
If an airborne infection isolation room (AIIR) is not available, place the patient in a private exam room with the door closed.
Call Louisville Metro Public Health and Wellness at 502-574-6675 to discuss testing as soon as measles is suspected.
Resources are available to assist with diagnosis and management.

This detection of measles in wastewater in Louisville occurs in the setting of an ongoing multi-state outbreak of measles in the United States. As of July 16, 2026, Kentucky has had 4 reported measles cases in 2026, although none of these have occurred in Jefferson County. Recent declines in MMR vaccination and greater global measles activity have contributed to the ongoing multi-state outbreak of measles in the United States. As of July 9, 2026, 2,218 confirmed measles cases have been reported in the United States in 2026 by 42 jurisdictions, in addition to 13 cases among international visitors.

The best way to prevent measles is through vaccination with two doses of the MMR vaccine. One dose is 93% effective at preventing measles and 2 doses are 97% effective at preventing measles. Vaccination is routinely recommended for children, with the first dose at 12-15 months of age and a second dose at 4-5 years of age. Adults without presumptive immunity are also recommended to receive 2 doses of the vaccine. Adults at high risk for measles include international travelers, students at post-high school education institutions, and healthcare personnel.

Kris Bryant, MD
Associate Medical Director
Louisville Metro Department of Public Health and Wellness

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