title: An expensive adult measles outbreak and response in office buildings during the era of accelerated measles elimination, Beijing, China.
abstract: Few measles outbreaks among adults are reported in China, and outbreak response costs are seldom documented. We report an adult measles outbreak and response in 4 linked office buildings in Beijing and its associated costs.
  
  
  
  The World Health Organization measles case definitions were used to determine suspected and confirmed measles cases. Surveillance data were used to describe the outbreak, and records and interviews of response staff were used to describe the response. Costs were determined by use of retrospective surveys of cases, review of records, and interviews of staff.
  
  
  
  The outbreak lasted 19days, and involved 22 cases aged 23-49years. Nineteen cases had a local household registration. All cases were employed by 8 companies in 4 linked office buildings. Among the 22 cases, 8 had temperature less than 38.5 degree, 18 had no Koplik spots and none had complications or hospitalizations. A total of 7930 contacts were identified, and of these, 6869 were employees in the office buildings. All the child contacts aged 8months-14years had been up-to-date for measles-containing vaccine (MCV); no adult could document their vaccination or measles history. Of contacts, about 96% were offered post-exposure vaccination. The total household costs were $13,298, or $605 per case. Control costs were $384,594, or $17,481 per case. Involved companies paid for 90.7% of control costs.
  
  
  
  Office buildings provide a mechanism for measles transmission. Timely control activities were challenged by the highly infectious nature of measles and mild presentations of cases. The outbreak response was very costly. Financial support by involved companies can provide needed resources for outbreak management.
authors.affiliation: EPI Department, Beijing Center for Disease Control and Prevention, Beijing 100013, PR China.
authors.forename: Rui
authors.initials: R
authors.lastname: Ma
authors.affiliation: EPI Department, Beijing Center for Disease Control and Prevention, Beijing 100013, PR China. Electronic address: lulibj@sina.com.
authors.forename: Li
authors.initials: L
authors.lastname: Lu
authors.affiliation: EPI Department, Beijing Center for Disease Control and Prevention, Beijing 100013, PR China.
authors.forename: Luodan
authors.initials: L
authors.lastname: Suo
authors.affiliation: EPI Department, Beijing Center for Disease Control and Prevention, Beijing 100013, PR China.
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Li
authors.affiliation: EPI Department, Beijing Center for Disease Control and Prevention, Beijing 100013, PR China.
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.affiliation: EPI Department, Beijing Center for Disease Control and Prevention, Beijing 100013, PR China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhou
authors.affiliation: EPI Department, Dongcheng District Center for Disease Control and Prevention, Beijing 101300, PR China.
authors.forename: Lijun
authors.initials: L
authors.lastname: Zhai
authors.affiliation: EPI Department, Dongcheng District Center for Disease Control and Prevention, Beijing 101300, PR China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Bai
authors.affiliation: EPI Department, Beijing Center for Disease Control and Prevention, Beijing 100013, PR China.
authors.forename: Xinghuo
authors.initials: X
authors.lastname: Pang
mesh_terms: D000293:Adolescent; D000328:Adult; D000068476:Beijing / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D004196:Disease Outbreaks; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000191:economics* / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D008458:Measles Vaccine / Q000008:administration & dosage; D008875:Middle Aged; D018103:Morbillivirus / Q000276:immunology / Q000472:pathogenicity*; D012189:Retrospective Studies; D014611:Vaccination
chemical_list: D008458:Measles Vaccine
keywords: Economic cost; Measles; Outbreak