1355. An Acute Care Hospital’s Outbreak Response to Measles in an Afghan Refugee Population

Abstract

Abstract Background The disruption of massive refugee evacuations in the fall of 2021 had subsequent downstream effects on the health care systems affected by such sudden human evacuations. Our 923-bed tertiary care facility in the Washington, D.C. metropolitan area admitted several refugees with acute measles infection. Gaps in surveillance for identifying infectious pathogens in our emergency department were identified and mitigation strategies were implemented in order to more rapidly identify suspected subsequent cases. Partnership with our local and state health departments were imperative in successfully identifying exposed persons, evaluating risk factors and administering post-exposure prophylaxis for at risk exposed persons. Methods Infection Preventionists identified exposed patients and team members, based on shared air spaces and time to include two hours after the infectious patient had left the area or had been placed on proper precautions. Following CDC and local health department guidance, over 500 charts of exposed patients were reviewed by a multidisciplinary team of physicians, nurses, pharmacists, and infection preventionists. Results Over 90 patients met criteria for and received post-exposure prophylaxis. 10 visitors, also refugees, were also given post-exposure prophylaxis. Standard operating procedures for hospital based measles exposure were further solidified through this exposure procedure. Written and verbal communications were updated for team members, patients and the community. No secondary cases of measles were seen in the hospitalized patients or in the community at large over the following 28 day observation period after last exposure. Numerous more cases of measles were noted in the refugee population evacuated over the following several weeks until MMR vaccination was widely distributed. Conclusion Consideration of infectious diseases in refugees with significant infectious exposure burden is imperative during times of massive refugee evacuations. Vaccination of refugees during evacuation and prior to resettlement is imperative. Evaluation for highly contagious diseases such as measles must be forefront in clinicians’ minds when encountering massive refugee evacuations. Disclosures All Authors: No reported disclosures.