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Measles: lessons from an outbreak.
I Gurevich1, R A Barzarga, B A Cunha
1Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501.
American Journal of Infection Control
|December 1, 1992
Summary
Hospital measles outbreaks reveal inadequate immunity guidelines. Doubling enzyme-linked immunosorbent assay (ELISA) titers and revaccinating staff improved protection against measles transmission.
Area of Science:
- Infectious Disease Epidemiology
- Hospital Infection Control
- Vaccinology
Background:
- Measles outbreaks pose significant challenges for hospital infection control, affecting patients and healthcare personnel.
- Existing guidelines for managing measles outbreaks among hospital staff are unclear and insufficient.
Observation:
- An investigation of a measles outbreak in a university-affiliated teaching hospital revealed substantial staff exposure.
- Four initial cases led to 607 staff exposures and two secondary infections, necessitating furloughs and vaccinations for 47 and 88 personnel, respectively.
Findings:
- Established serologic criteria for measles immunity proved inadequate during the outbreak.
- Minimal enzyme-linked immunosorbent assay (ELISA) antibody titers were insufficient to prevent secondary transmission.
Implications:
- Adjusting serologic immunity thresholds, such as doubling ELISA titers, may be necessary during hospital measles outbreaks.
- Revaccination strategies leveraging the anamnestic response can enhance protection in healthcare workers with low measles antibody titers.
- Revised guidelines are needed to effectively manage measles immunity and prevent outbreaks in healthcare settings.