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Transmission of Measles Virus in Healthcare Settings During a Communitywide Outbreak

Published online by Cambridge University Press:  02 January 2015

Karen R. Steingart ,
Ann R. Thomas ,
Clare A. Dykewicz  and
Stephen C. Redd
Karen R. Steingart*
Affiliation:
Southwest Washington Health District, Vancouver, Washington
Ann R. Thomas
Affiliation:
Division of Applied Public Health, Epidemiology Program Office
Clare A. Dykewicz
Affiliation:
Division of AIDS, STD, and TB Laboratory Research, Office of the Director, National Center for Infectious Diseases
Stephen C. Redd
Affiliation:
Environmental Hazards and Health Effects Division, Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Southwest Washington Health District, 2000 Fort Vancouver Way, Vancouver, WA 98663
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Abstract

Objective:

To describe the epidemiology of measles in medical settings and to evaluate the implementation and effectiveness of the 1989 Advisory Committee on Immunization Practices (ACIP) guidelines for measles immunization in healthcare workers (HCWs).

Design:

Confirmed cases of measles reported in Clark County, Washington, from March 14 to June 2,1996, were analyzed for characteristics of cases occurring in medical settings. A questionnaire was used to assess employee immunization (95% response rate).

Setting and Participants:

Reported measles cases and HCWs at community hospitals, primary-care medical facilities, a health-maintenance organization, and a multispecialty group practice.

Results:

Of 31 cases of measles, 8 (26%) occurred in HCWs, and 5 (16%) occurred in patients or visitors to medical facilities. Cases of measles occurred in HCWs who were not required to have proof of measles immunity as defined by the 1989 ACIP guidelines. The relative risk of measles in HCWs compared to Clark County adults was 18.6 (95% confidence interval, 7.4-45.8; P<.001).

A survey of medical facilities revealed that 47% had an employee measles immunization policy; only 21% met ACIP recommendations and enforced their policies.

Conclusions:

HCWs were at higher risk of measles than the adult population. Transmission of measles in medical settings was related to both deficiencies in, and lack of implementation of, the ACIP guidelines.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 2 , February 1999 , pp. 115 - 119
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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