Consequences of an unrecognized measles exposure in an emergency department

A recent measles case in a paediatric hospital ED resulted in 111 individuals (patients, family members and health-care workers) potentially being exposed to measles. This report documents the efforts taken to contact trace and provide best practice care for all those exposed to the index case. It also provides a snapshot of community prevalence information on immunity to measles. One hundred per cent of contacted children (n = 24) eligible for vaccination were immunized, whereas 96% of adults surveyed or tested (n = 44) had assumed or proven immunity. However, six infants aged between 6 and 9 months were exposed and might have been a sufficiently large reservoir to facilitate the ongoing spread of measles in the community, if contact tracing and preventative measures had not occurred. This scenario also highlights the need to consider measles in the ED, particularly among travellers, with urgent isolation of suspected cases in the ED according to guidelines discussed.