alexa Health care-associated measles outbreak in the United States after an importation: challenges and economic impact.


Journal of Vaccines & Vaccination

Author(s): Chen SY, Anderson S, Kutty PK, Lugo F, McDonald M,

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Abstract BACKGROUND: On 12 February 2008, an infected Swiss traveler visited hospital A in Tucson, Arizona, and initiated a predominantly health care-associated measles outbreak involving 14 cases. We investigated risk factors that might have contributed to health care-associated transmission and assessed outbreak-associated hospital costs. METHODS: Epidemiologic data were obtained by case interviews and review of medical records. Health care personnel (HCP) immunization records were reviewed to identify non-measles-immune HCP. Outbreak-associated costs were estimated from 2 hospitals. RESULTS: Of 14 patients with confirmed cases, 7 (50\%) were aged ≥ 18 years, 4 (29\%) were hospitalized, 7 (50\%) acquired measles in health care settings, and all (100\%) were unvaccinated or had unknown vaccination status. Of the 11 patients (79\%) who had accessed health care services while infectious, 1 (9\%) was masked and isolated promptly after rash onset. HCP measles immunity data from 2 hospitals confirmed that 1776 (25\%) of 7195 HCP lacked evidence of measles immunity. Among these HCPs, 139 (9\%) of 1583 tested seronegative for measles immunoglobulin G, including 1 person who acquired measles. The 2 hospitals spent US$799,136 responding to and containing 7 cases in these facilities. CONCLUSIONS: Suspecting measles as a diagnosis, instituting immediate airborne isolation, and ensuring rapidly retrievable measles immunity records for HCPs are paramount in preventing health care-associated spread and in minimizing hospital outbreak-response costs. This article was published in J Infect Dis and referenced in Journal of Vaccines & Vaccination

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