Related Experiment Videos
Measles transmission in health facilities during outbreaks
A C Miranda1, J Falcão, J A Dias
1ROR-Sul, IPOFG-Centro de Lisboa, Portugal.
Insights
Children in medical waiting rooms face a higher risk of measles infection during outbreaks. Avoiding crowded settings and ensuring immunization are key protective measures against contracting measles in healthcare environments.
Area of Science:
- Epidemiology
- Pediatrics
- Infectious Diseases
Background:
- Medical waiting rooms increase children's risk of infectious diseases, particularly during outbreaks.
- Measles outbreaks pose a significant threat in pediatric healthcare settings.
Purpose of the Study:
- To estimate the risk of measles infection acquired in medical settings during a 1989 outbreak in Lisbon.
- To identify factors associated with measles transmission in a major pediatric hospital.
Main Methods:
- A case-control study involving 72 measles cases and 216 controls in children under 12.
- Conditional logistic regression analysis, matched on age, to develop a multivariate risk model.
Main Results:
- Children under 12 had a 4.1-fold increased odds of measles from medical setting exposure.
- Hospital emergency settings showed higher odds (OR=4.9) compared to private physicians' offices (OR=1.4).
- Measles immunization was a strong protective factor (OR=0.1), while contact with infected individuals significantly increased risk (OR=14.7).
Conclusions:
- Children should avoid unnecessary exposure in crowded medical settings during measles outbreaks.
- Minimizing wait times and prioritizing vaccination are crucial for preventing measles transmission in healthcare environments.
Background:
Consultation waiting rooms and similar medical settings, either public or private, are places where children have higher probability of acquiring some infectious diseases, especially during outbreaks.
Methods:
During a measles outbreak which occurred in Lisbon in 1989 a case-control study was carried out in a major paediatric hospital to estimate the risk of measles infection associated with the exposure in medical settings. The statistical analysis was performed with data matched on age, using conditional logistic regression, to reach a multivariate model which explains the risk in the presence of the main variables of interest.
Results:
The crude odds ratio (OR), based upon 72 cases and 216 controls, in children younger than 12 years, was 4.1 (P < 0.001). Hospital emergency settings had an OR of 4.9 (P < 0.001) and private physicians' offices an OR of 1.4 (P = 0.689). Non-whites showed a 2.4-fold increase in the crude probability of getting measles, although this was not statistically significant (P = 0.118). Children who had a recent contact with cases of measles had an OR of 14.7 (P = 0.005). Immunization against measles was an important protective factor (OR = 0.1; P < 0.001), as was attendance at kindergartens or wet nurses, although less significant (OR = 0.4; P = 0.051).
Conclusions:
This study supports the need for children to avoid unnecessary exposure in medical settings during measles outbreaks, especially if those settings are crowded and result in long waiting periods before a consultation.