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The hospital as a vector of measles in the community
Abstract:
Over a 16-month period 77 consecutive cases of life-threatening measles admitted to the intensive care unit of the Red Cross War Memorial Children's Hospital were surveyed. Twenty-eight children died and 9 were left with chronic respiratory disease. Twenty of these 77 children probably caught the disease in hospital. Of these, 10 (50%) died compared with 18 (32%) of the 57 who acquired measles in the community, confirming that hospital-acquired measles is particularly severe. It is concluded that hospitals contribute substantially to the spread of measles in the community. Optimal strategies for dealing with this problem are urgently needed.
Insights
Hospital-acquired measles is particularly severe, with a higher mortality rate than community-acquired cases. Hospitals significantly contribute to measles spread, necessitating urgent control strategies.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hospital Epidemiology
Background:
- Measles is a highly contagious viral illness.
- Life-threatening measles cases require intensive care.
- Hospital settings can be a source of infectious disease transmission.
Purpose of the Study:
- To assess the severity and outcomes of life-threatening measles cases admitted to intensive care.
- To determine the proportion of measles cases acquired within a hospital setting.
- To compare the mortality rates of hospital-acquired versus community-acquired measles.
Main Methods:
- A 16-month survey of 77 consecutive severe measles admissions to an intensive care unit.
- Retrospective analysis of patient data, including place of measles acquisition.
- Comparison of mortality and morbidity between hospital-acquired and community-acquired measles.
Main Results:
- Twenty-eight children (36%) died, and 9 (12%) developed chronic respiratory disease.
- Twenty children (26%) likely acquired measles in the hospital.
- Mortality was higher for hospital-acquired measles (50%) compared to community-acquired measles (32%).
Conclusions:
- Hospital-acquired measles is associated with significantly increased severity and mortality.
- Hospitals play a substantial role in the community spread of measles.
- Urgent development and implementation of optimal strategies are needed to prevent hospital-acquired measles and reduce transmission.