Outbreak response operations during the US measles epidemic, 2017-19

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Control

Background:

• US measles outbreaks occurred in 2017-2019, highlighting the need to understand operational challenges.
• Focus on specific operational barriers and recommendations for outbreak responses among insular communities.

Purpose of the Study:

• To understand operational challenges in responding to US measles outbreaks (2017-2019).
• To identify lessons learned for future outbreak preparedness and response operations.
• To specifically address operational barriers in insular communities.

Main Methods:

• Conducted 11 telephone interviews with 18 participants from state/local health departments and community health centers.
• Participants responded to US measles outbreaks in 2017-2019, with a focus on insular communities.
• Employed qualitative, thematic coding to identify operational challenges and lessons.

Main Results:

• Key insights categorized into: scale of response, vaccination operations, exclusion policies, community engagement, and countering anti-vaccine efforts.
• Identified resource-intensive aspects: personnel demands, guidance for response operations, and transmission reduction strategies.
• Highlighted operational challenges in vaccination and response activities, and effective engagement with affected populations, especially insular and vulnerable communities.

Conclusions:

• Measles outbreak responses are resource-intensive and can strain public health capacities.
• Early, effective coordination with trusted community leaders and organizations is vital for efficient response.
• Firsthand experiences offer evidence-based operational lessons for future preparedness and response to highly transmissible diseases.