Measles outbreak related to healthcare transmission

Abstract

IntroductionMeasles has a high transmission rate among susceptible populations. Healthcare facilities can play an important role in measles transmission. The aim of this study is to describe a measles outbreak in a highly immunized community and the implication of healthcare workers in the transmission of the disease. MethodsDescriptive study of measles outbreak linked to hospital setting with sociodemographic, clinical, virological and immunization variables studied. Cases were confirmed by RT-PCR in clinical specimens and genotyped by nucleotide sequencing. Association was assessed by chi2, Fisher's exact and z test. Statistical significance at p=0.05. Results47 suspected measles cases were reported from March to June 2018 at Terres de l’Ebre, Catalonia. Fourteen cases were confirmed, 8 cases (57%) were men; median age of cases 33y (range 16–46 y). Hospital associated transmission was confirmed in 13 (93%) cases, 8 (61.5%) were hospital staff. Five (38.5%) were healthcare workers (HCW), three (23%) non-healthcare workers (non-HCW) and 6 (46%) were patients attended at the hospital. Four cases (28.5%) were immunized with 2 doses of measles virus containing vaccine (MCV); 3 (75%) were HCW. No statistical difference observed among hospital staff and community cases as to immunization (OR 2.4 95%CI: 0.17–32.88; p=0.49). Genotype B3 MVs/Dublin.IRL/8.16-variant was obtained from confirmed cases. ConclusionSuspecting measles diagnosis, allows for immediate airborne isolation, and retrieving measles immunity records for healthcare facility employees and contacts. Vaccination of HCW and the adoption of good infection control will minimize nosocomial transmission and spreading of the virus to the community.