1738. Measles Exposures at a Children’s Hospital – Not the “Happiest Place on Earth"
Session: Poster Abstract Session: Outbreaks of Bad Bugs and Prevention in Children
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • IDWeek Poster 2015 Measles 2.png (921.9 kB)
  • Background:

    Measles is a highly contagious airborne transmissible viral infection. Our outbreak was January 1 - March 4, 2015 and ended April 17, 2015. During this outbreak, there were 35 confirmed cases in Orange County, California including 14 children. We describe the exposure impact of 8 measles cases at our facility.

    Methods:

    Due to measles cases in our community in 2014, Infection Prevention receives daily measles orders for initiation of airborne isolation.  Exposure definitions were updated. Public health alerts were shared. Suspect cases were masked and put in airborne isolation. Eventually all patients presenting to Emergency Dept. (ED) and clinics were masked. Computerized measles order sets were established. Lack of rapid resulting of polymerase chain reaction and immunoglobulin (IG) M delayed case confirmation. Exposed patients and staff were screened to determine the need for prophylaxis with IG and MMR vaccine. Costs were calculated.

    Results:

    From 1/1- 4/17/15, we had 8 confirmed measles cases (5 admitted and 3 ED) and 2 presumed vaccine-related measles. There were 51 patients who had measles ruled out. Isolation was initiated correctly for 56 of the 61 patients (92%). There were 501 patients potentially exposed by our first 5 measles patients (Table 1). There were no secondary cases.

    Conclusion:

    Young healthcare providers may not recognize measles and the importance of immediate airborne isolation to prevent exposures. These exposures are time consuming and costly. Education regarding specific vaccine preventable diseases and general principles of infection prevention are crucial.

    Table 1. Measles Exposures and Related Costs

    Patient

    Age

    Exposure Time

    Patients Exposed

    Received IG / Needed IG

    IG Cost
    ($)

    Received MMR / Needed MMR

    MMR Cost
    ($)

    Letters Sent

    Staff Immune / Staff Exposed

    1

    3 yr

    21 hrs

    42

    7/7

    695.08

    Out of window

    0

    15

    68/68

    2

    8 mo

    2 hrs, 21 min

    53

    9/13

    1048.89

    Out of window

    0

    53

    41/41

    3

    15 mo

    4 hrs, 25 min

    77

    13/19

    1857.34

    Out of window

    0

    77

    32/32

    4

    3 yr

    2 hrs, 30 min

    47

    4/5

    1772.51

    3/7

    170.48

    47

    43/43

    5

    14 mo

    6 hrs, 42 min

    77

    13/17

    1846.69

    Out of window

    0

    77

    28/28

    4 hrs, 51 min

    205

    44/53

    9038.67

    15/26

    852.41

    205

    50/50

    2 hrs

    0

    0

    0

    0

    0

    0

    8/8

    6

    14 mo

    7 hrs, 10 min

    0

    0

    0

    0

    0

    0

    0

    7

    9 mo

    2 hrs, 59 min

    0

    0

    0

    0

    0

    0

    0

    8

    9 mo

    4 hrs, 1 min

    0

    0

    0

    0

    0

    0

    0

    Total

    501

    90/114 (79%)

     $16,259.18

    18/33

    (55%)

     $1,022.89

    474

    270

    Wendi Gornick, MS, CIC1, Carolyn Khong, MPH1, Reggie Rogers, RN, BSN, CIC1, Maximillian Jahng, PharmD2 and Jasjit Singh, MD3, (1)Infection Prevention and Epidemiology, CHOC Children's Hospital, Orange, CA, (2)Pharmacy, CHOC Children's Hospital, Orange, CA, (3)Infectious Diseases, CHOC Children's Hospital, Orange, CA

    Disclosures:

    W. Gornick, None

    C. Khong, None

    R. Rogers, None

    M. Jahng, None

    J. Singh, Sanofi: Speaker's Bureau , Speaker honorarium

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