title: Hospital preparedness in community measles outbreaks-challenges and recommendations for low-resource settings.
abstract: We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks. The strategies that are more applicable to resource-poor settings, such as natural ventilation, mechanical ventilation with heating and air-conditioning systems allowing unidirectional air-flow, and protection of un-infected patients and healthcare workers (HCWs), have been examined. Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact. Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission within facilities.
authors.affiliation: Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.|Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan; sadia.shakoor@aku.edu.
authors.forename: Sadia
authors.initials: S
authors.lastname: Shakoor
authors.affiliation: Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
authors.forename: Fatima
authors.initials: F
authors.lastname: Mir
authors.affiliation: Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
authors.forename: Anita K M
authors.initials: AK
authors.lastname: Zaidi
authors.affiliation: Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.
authors.forename: Afia
authors.initials: A
authors.lastname: Zafar
mesh_terms: D000391:Air Microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D004196:Disease Outbreaks / Q000517:prevention & control; D019983:Guideline Adherence; D006282:Health Personnel; D006749:Hospital Design and Construction / Q000379:methods*; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000592:standards; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D008458:Measles Vaccine / Q000008:administration & dosage*; D056990:Post-Exposure Prophylaxis / Q000379:methods; D014691:Ventilation / Q000295:instrumentation / Q000379:methods
chemical_list: D008458:Measles Vaccine
keywords: Measles; airborne isolation; hospital; infection control; natural ventilation