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Measles

Hilary M. Babcock, MD, MPH, on Ensuring Staff Immunity During Disease Outbreaks

Measles was declared eradicated from the United States in 2000. However, the 2019 measles outbreak reminded us that it is still a dangerous, and deadly, virus.

A session at IDWeek 2019 focused on ensuring health care personnel immunity during disease outbreaks and other lessons from the 2019 measles outbreak.1

Infectious Diseases Consultant caught up with speaker Hilary M. Babcock, MD, MPH—professor of medicine in the Division of Infectious Diseases at the Washington University School of Medicine and is the medical director of the BJC Infection Prevention and Epidemiology Consortium at BJC Healthcare in St. Louis, Missouri—before her session.

INFECTIOUS DISEASE CONSULTANT: Which infection control measures are necessary when transferring and evaluating patients with potential measles exposure, infection, or complications?

Hilary Babcock: It is imperative that all staff, including emergency medical service personnel, are immune to measles. Immunity is the first line of defense. Even for immune staff, personal protective equipment is also recommended to decrease the risk of transmission. Appropriate personal protective equipment for measles includes wearing a respirator, usually an N95 mask. In health care settings, patients with known or suspected measles need to be isolated in a single room with special air handling—negative pressure ventilation that prevents any particles carrying the measles virus from escaping from the room and infecting others.

ID CON: Which control measures have proven successful in ensuring medical staff immunity?

HB: The measles-mumps-rubella vaccine is a highly effective vaccine, and ensuring that all staff have been vaccinated is critical. Comprehensive, electronic records for occupational health services in health care settings makes it possible to quickly review the immune status of staff so that potentially nonimmune staff can be tested and vaccinated if needed.

ID CON: What has been learned from the 2019 measles outbreak?

HB: Measles is one of the most highly contagious infections, with a single case resulting in multiple secondary cases in nonimmune populations. High levels of immunity in the community are needed to keep everyone protected.

ID CON: What is the key take-home message for public health professionals and other ID specialists?

HB: During this year of resurgent measles cases in many countries, including the United States, we have been reminded of the importance of maintaining high vaccination rates and of the consequences of the illness—even death—when measles cases occur. We must all remain vigilant and engage broadly with our communities to encourage vaccination and reassure concerned parents about the safety of the vaccine.

Reference:

  1. Babcock HM. Occupational health practical issues: ensuring staff immunity. Talk presented at: IDWeek 2019; October 2-6, 2019; Washington, DC. https://www.eventscribe.com/2019/IDWeek/fsPopup.asp?Mode=presInfo&PresentationID=589946.