Measles: lessons from an outbreak.
BACKGROUND
Measles outbreaks continue to be a problem for infection control in hospitals--patients, personnel, and employee health service. Guidelines for measles outbreaks are not clear for medical personnel in the hospital.


METHODS
Outbreak investigation in a university-affiliated teaching hospital.


RESULTS
Four primary cases resulted in 607 staff exposures and two secondary cases. Forty-seven medical personnel were furloughed and 88 were vaccinated for measles. Minimal serologic criteria for immunity were found to be inadequate in the outbreak setting.


CONCLUSIONS
We found that serologic guidelines for assessing immunity to measles are inadequate. During the outbreak, we arbitrarily doubled the acceptable enzyme-linked immunosorbent assay titers that we would consider protective, > or = 2, to decrease the possibility of further secondary cases. Employees with enzyme-linked immunosorbent assay measles titers less than 2 and without a definite history of natural measles were revaccinated with a measles vaccine. This strategy takes advantage of the anamnestic response that revaccination would confer in persons with low antibody titer.
Gurevich
I
I
Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501.
Barzarga
R A
RA
Cunha
B A
BA
D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006785:Hospitals, University / Q000592:standards*; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control / Q000635:transmission; D008458:Measles Vaccine; D009518:New York / Q000453:epidemiology; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D014611:Vaccination
D000914:Antibodies, Viral; D008458:Measles Vaccine