Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-29T07:58:38.447Z Has data issue: false hasContentIssue false
  • English
  • Français

The Importance of Nosocomial Transmission of Measles in the Propagation of a Community Outbreak

Published online by Cambridge University Press:  21 June 2016

Issam I. Raad ,
Robert J. Sherertz ,
Caroline S. Rains ,
Janet L. Cusick ,
Loretta L. Fauerbach ,
Peter D. Reuman  and
Tom R. Belcuore
Issam I. Raad
Affiliation:
Departments of Medicine, Gainesville, Florida
Robert J. Sherertz*
Affiliation:
Departments of Medicine, Gainesville, Florida
Janet L. Cusick
Affiliation:
Shands Hospital Employee Health, Gainesville, Florida
Loretta L. Fauerbach
Affiliation:
Shands Hospital Infection Control, Gainesville, Florida
Peter D. Reuman
Affiliation:
Pediatrics, Gainesville, Florida
Tom R. Belcuore
Affiliation:
University of Florida, and Alachua County Public Health, Gainesville, Florida
*
Division of Infectious Diseases, Department of Medicine, Bowman Gray School of Medicine, 300 S. Hawthorne Road, Winston-Salem, NC 27103
Get access Rights & Permissions [Opens in a new window]

Abstract

In late January 1985, a measles outbreak occurred at a community hospital in Columbia county, Florida. The outbreak spread throughout the county and to two neighboring counties (Alachua and Marion), resulting in 79 cases with a 29% hospitalization rate. Hospitals represented the site with the highest frequency of transmission. At the Alachua county hospitals, where strict respiratory isolation measures were taken, no secondary cases occurred among hospitalized patients. Two independent risk factors existed for hospitalization: measles exposure in a hospital setting (P <0.05) and nonvaccination (P <0.00l). Of the total measles cases, 24% were under the age of 16 months and 47% of those aged 16 months or older had a history of appropriate vaccination. Columbia county, which experienced 86% of the cases, had a 5% frequency of unvaccinated students compared to 0.6% frequency at Alachua (P <0.00l) where only 10% of the cases occurred. This outbreak demonstrates the role of uncontrolled nosocomial transmission of measles in the propagation of a community outbreak.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 4 , April 1989 , pp. 161 - 166
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Centers for Disease Control: Measles-United States, 1986. MMWR 1987; 36:301–306.Google Scholar
2. Centers for Disease Control: Measles prevention. MMWR 1987; 36:409–425.Google Scholar
3. Centers for Disease Control: Measles on college campuses-United Starer, 1985. MMWR 1985; 34:445–449.Google Scholar
4. Krause, PJ, Cherry, JD. Deseda-Tous, J, et al: Epidemic measles in young adults: Clinical, epidemiologic, and serologic studies. Ann Intern Med 1979; 90:873–876.10.7326/0003-4819-90-6-873CrossRefGoogle ScholarPubMed
5 Centers for Disease Control: Measles-North America. 1984. MMWR 1985; 34:366–370.Google Scholar
6. Preblud, SK, Gross FHalsey, NA, et al: Assessment of susceptibility to measles and rubella. JAMA 1982; 247:1134–1137.10.1001/jama.1982.03320330030021CrossRefGoogle ScholarPubMed
7. Davis, RM, Orenstein, WA, Frank, JA, et al: Transmission of measles in medical settings. JAMA 1986; 255:1295–1298.10.1001/jama.1986.03370100089023CrossRefGoogle ScholarPubMed
8. Centers for Disease Control: Measles-United States, 1985. MMWR 1986; 35:366–370.Google Scholar
9. Dales, LG, Kizer, KU’: Measles transmission in medical facilities. West J Med 1985; 142:415–416.Google ScholarPubMed
10. Sienko, DG, Friedman, C. McGee, HB. et al: A measles outbreak at university medical settings involving health care providers. Am J Public Health 1987: 77:1222–1224.10.2105/AJPH.77.9.1222CrossRefGoogle ScholarPubMed
11. Centers for Disease Control: Measles-New Hampshire. MMWR 1984: 33:549–559.Google Scholar
12. Centers for Disease Control: Measles transmitted in a medical office building-New Mexico. 1986. MMWR 1987; 36:25–27.Google Scholar
13. Watkins, NM, Smith, RP, St. Germain, DL. et al: Measles (rubeola) infection in a hospital setting. Am J Infect Control 1987; 15:201–206.10.1016/0196-6553(87)90096-4CrossRefGoogle ScholarPubMed
14. Centers fot Disease Control: Imported measles with subsequent airborne transmission in a pediatricians office-Michigan. MMWR 1983; 32:401–402.Google Scholar
15. Foulon G. Gottin, JF, Matheron, S, et al: Transmission and severity of measles acquired in medical settings. JAMA 1986; 256:1 135.Google Scholar
16. Centers for Disease Control: Measles nearly eliminated, but still poses nosocomial risk. Hosp Infect 1982; 9: 133–h.Google Scholar
17. Centers for Disease Control: Measles—Los Angeles Country, California, 1988. MMWR 1989; 38:49–57.Google Scholar
18. Centers for Disease Control: Measles prevention: Supplementary statement. MMWR 1989; 38: 1 1–14.Google Scholar
19. Davis, RM, Markowitz, LE. Preblud, SK. et al: A cost-effectiveness analysis of measles outbreak control strategies. Am .I Epidemiol 1987; 126:450–459.CrossRefGoogle ScholarPubMed
20. Markowitz, LE. Preblud, SK, Orenstein, WA. et al: Patterns of transmission in measles outbreaks in thr United States, 1985–1986. N Engl J Med 1989; 320:75–81.10.1056/NEJM198901123200202CrossRefGoogle Scholar
21. Centers tor Disease Control: Measles in a day care center: Washington. MMWR 1980; 29:426–427.Google Scholar
22. Ruuskanen, O, Salmi, TT, Holonen, P: Measles vaccination after exposure to natural measles. J Pediatr 1978; 93:43–46.10.1016/S0022-3476(78)80597-6CrossRefGoogle ScholarPubMed
23. Gustafson, TL, Lievens, AW, Brunell, PA, et al: Measles outbreak in a fully immunized secondary-school population. N Engl J Med 1987; 316:771–774.10.1056/NEJM198703263161303CrossRefGoogle Scholar