Syndromic surveillance for measleslike illnesses in a managed care setting

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Surveillance

Background:

• Measles elimination in the U.S. requires enhanced surveillance strategies.
• Febrile rash illnesses often mimic measles, necessitating thorough investigation.
• Limited data exist on the incidence and provider evaluation of measles-like illnesses (MLIs).

Purpose of the Study:

• To determine the incidence of MLIs within a large managed care organization.
• To understand how healthcare providers evaluate patients presenting with MLIs.
• To assess the current practices for measles diagnosis and reporting.

Main Methods:

• Retrospective analysis of patient encounters from a managed care organization database (1994-1998).
• Identification of cases meeting the study's definition for MLI.
• Review of medical records to ascertain diagnostic considerations and actions taken by physicians.

Main Results:

• An incidence rate of 4.5 MLIs per 100,000 person-years was observed.
• Physicians considered measles diagnoses in only 13.2% of identified MLI cases.
• Of those considered, only 2 cases were laboratory-tested and reported; 7 received alternative diagnoses.

Conclusions:

• Provider education on evaluating and reporting potential measles cases is essential.
• Managed care organization databases are valuable for public health surveillance of communicable diseases.
• Strengthening syndromic surveillance systems can aid in achieving measles elimination.