Methods: We reviewed Hospital A inpatients and staff records to identify persons who might have shared airspace with the visitor (contacts). Neonates, pregnant women, and immunocompromised contacts were considered at high risk for measles complications. Contacts at high risk without documented immunity were offered measles immunoglobulin postexposure prophylaxis (PEP). We assessed Hospital A’s infection control practices including visitor screening procedures.
Results: We identified 112 contacts at high risk. Among 14 pregnant contacts, all 4 without documented immunity received PEP. Among 98 infant contacts, 70 (71%) received PEP; 23 (23%) guardians declined PEP on behalf of their infant; and 5 (5%) were lost to follow-up. Among 237 hospital staff contacts, 8 lacked documented immunity and were furloughed; none were at high risk. NICU inpatients sharing the room visited by the infectious visitor were cohorted in an airborne infection isolation area. No other cases were identified. Observed infection control and screening practices were insufficient to prevent the symptomatic visitor from entering the NICU and labor and delivery ward.
Conclusion: Infection control and visitor screening practices should be properly implemented. Targeted education of patient guardians and providers is necessary to increase adherence to measles PEP recommendations for contacts at high risk for measles complications.
J. Rutledge, None
J. Zipprich, Pfizer: Spouse works at Pfizer , Salary
M. Morrisson, None
K. Harriman, None
K. Bird, None