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The Importance of Nosocomial Transmission of Measles in the Propagation of a Community Outbreak

Published online by Cambridge University Press:  21 June 2016

Issam I. Raad
Affiliation:
Departments of Medicine, Gainesville, Florida
Robert J. Sherertz*
Affiliation:
Departments of Medicine, Gainesville, Florida
Janet L. Cusick
Affiliation:
Shands Hospital Employee Health, Gainesville, Florida
Loretta L. Fauerbach
Affiliation:
Shands Hospital Infection Control, Gainesville, Florida
Peter D. Reuman
Affiliation:
Pediatrics, Gainesville, Florida
Tom R. Belcuore
Affiliation:
University of Florida, and Alachua County Public Health, Gainesville, Florida
*
Division of Infectious Diseases, Department of Medicine, Bowman Gray School of Medicine, 300 S. Hawthorne Road, Winston-Salem, NC 27103

Abstract

In late January 1985, a measles outbreak occurred at a community hospital in Columbia county, Florida. The outbreak spread throughout the county and to two neighboring counties (Alachua and Marion), resulting in 79 cases with a 29% hospitalization rate. Hospitals represented the site with the highest frequency of transmission. At the Alachua county hospitals, where strict respiratory isolation measures were taken, no secondary cases occurred among hospitalized patients. Two independent risk factors existed for hospitalization: measles exposure in a hospital setting (P <0.05) and nonvaccination (P <0.00l). Of the total measles cases, 24% were under the age of 16 months and 47% of those aged 16 months or older had a history of appropriate vaccination. Columbia county, which experienced 86% of the cases, had a 5% frequency of unvaccinated students compared to 0.6% frequency at Alachua (P <0.00l) where only 10% of the cases occurred. This outbreak demonstrates the role of uncontrolled nosocomial transmission of measles in the propagation of a community outbreak.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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