Sarampo: protocolo de atuação num Hospital Português

Abstract

Introduction Measles is a highly contagious infectious disease caused by a paramyxovirus. In the last six decades, the promotion of vaccination against this disease has drastically reduced its incidence. Despite this, in 2016, around seven million new infections were diagnosed. Since healthcare workers have an increased risk of infection, the promotion of vaccination by the Occupational Health Services represents one of the main strategies to consolidate the eradication of this pathology in Portugal. Objectives Review the clinical aspects and prevention measures of Measles with a focus on vaccination and present post-exposure prophylaxis measures for healthcare workers in a Portuguese hospital. Methodology It was performed a literature search about the clinical and preventive aspects of Measles using the main guidelines of organizations, such as the Direção-Geral da Saúde and Centers for Disease Control and Prevention, and through identification of scientific articles on PubMed/MEDLINE databases. Results/Discussion This infection has an incubation period that can last between seven to twenty-one days, and it’s followed by the prodromal, exanthematic, and recovery phases. Infected patients are contagious four days before and four days after the rash appears. The diagnosis is based on clinical, laboratory and epidemiological criteria. A confirmed case of Measles must meet clinical and laboratory criteria. The treatment is based on supportive care, to prevent dehydration. Vaccination is the best preventive measure against this disease. All healthcare workers without a credible history of Measles should have two vaccine doses. In an outbreak context, exposed workers must be identified and the Occupational Health Departments must apply appropriate post-exposure prophylaxis measures, as well as define which employees require work avoidance and for how long. Conclusion The existence of well-defined action plans for healthcare workers who had contact with infected patients is essential to minimize the occurrence of intra-hospital transmission chains and the subsequent infection of people at higher risk of complications from the disease. The presented protocol allows acting clearly and concisely when dealing with a suspected or confirmed Measles case and its contacts and provides a succinct review of the clinical, therapeutic and preventive data of this pathology. Keywords: Measles; Measles vaccine; Vaccination; Outbreak; Prevention; Occupational Health.