Respiratory Illness and Measles Updates for Virginia
January 21, 2026
Dear Colleague:
Virginia has been experiencing an active respiratory illness season and has reported multiple recent measles cases and exposures. This letter shares important reminders for keeping yourself and your patients healthy.
Prevent Respiratory Illnesses
As of January 17, the level of respiratory illnesses is now low in Virginia. This follows recent high levels of activity, primarily driven by influenza (flu) illnesses. While flu activity has been trending down, Virginia is still reporting elevated levels of patients hospitalized with flu and, sadly, reported the first flu-associated pediatric death last week. It is also still early in the respiratory season, and we have observed bimodal peaks in previous years.
It is still a good time for people to get a flu vaccine, if they have not already. Encourage flu vaccination for eligible patients and staff. Vaccination is particularly important for people who are at higher risk of serious complications from flu.
Influenza Testing and Treatment:
- Rapidly submit influenza specimens to DCLS that were unable to be subtyped using a test that is capable of providing a subtype, but failed to do so (e.g., Biofire, ePlex). The DCLS Influenza Test Request Form should indicate ‘Influenza A subtype EQUIVOCAL/Influenza A subtype NOT DETECTED’.
- If Avian A(H5N1) or a novel infection is suspected based on clinical or epidemiologic risk factors, contact your local health department by the most rapid means possible to report and request testing at the Division of Consolidated Laboratory Services (DCLS).
- Promptly prescribe FDA-approved influenza antiviral medications for patients with influenza who are hospitalized; patients who have severe, complicated, or progressive illness; or patients at higher risk for influenza complications.
- During times of elevated influenza activity, VDH recommends that providers prioritize the use of oseltamivir for hospitalized patients and high-risk outpatients early in the course of illness, and consider therapeutic substitution with non-oseltamivir products when clinically appropriate. Although we are not aware of significant shortages in Virginia, if you experience shortages of oseltamivir, please report that information rapidly through your local health department.
VDH maintains resources for healthcare facilities and the public to help prevent transmission of respiratory viruses and monitor local respiratory illness metrics.
Stay Alert for Measles
Virginia clinicians are asked to stay alert for measles given recent cases and exposure events in Virginia and other ongoing measles outbreaks in the United States and abroad. Consider measles, particularly in patients with fever and a generalized maculopapular rash who have recently traveled out of the country or to regions of the United States reporting measles outbreaks. Other symptoms include cough, coryza, or conjunctivitis.
If you suspect measles:
- Isolate: Immediately isolate the patient in a single-patient airborne infection isolation room (AIIR), or in a private room with a closed door until an AIIR is available.
- Notify: Immediately notify your local health department to ensure rapid testing and investigation.
- Test: Submit a nasopharyngeal (NP) swab in VTM or UTM for PCR testing and a bloodserum specimen for serology testing at DCLS. Follow instructions for specimen collection and handling. Test results are available in less than 24 hours.
Develop a plan for measles prevention and control:
- Ensure healthcare systems can rapidly retrieve employee immunization statuses. MMR vaccine is recommended for all healthcare workers who do not have documented evidence of measles immunity.
- Be prepared to identify all potentially exposed patients, visitors, and staff during times when appropriate transmission-based precautions were not in place.
- Establish protocols for administering post-exposure prophylaxis, and ensure adequate supply of MMR vaccine, IVIG, and IMIG.
- Make sure that patients are up to date on recommended measles vaccines, especially before international travel, regardless of destination. Infants six through eleven months of age who will be traveling internationally, or to an outbreak setting, should receive one dose of MMR vaccine prior to travel.
- Visit VDH’s Measles Information for Healthcare Providers to stay up to date on measles.
Thank you for your continued partnership in keeping Virginians safe and healthy.
Sincerely,
B. Cameron Webb, MD, JD
State Health Commissioner