Measles transmission in health care waiting rooms: implications for public health response

Hope, Kirsty; Boyd, Rowena; Conaty, Stephen; Maywood, Partrick

doi:10.5365/wpsar.2012.3.3.009

Cited by 28 publications

(28 citation statements)

References 11 publications

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“…Measles surveillance systems will not always identify every case of disease, 13,24 as evidenced by the retrospective identification of measles index cases in emergency department outbreaks 13,25,26 and through analysis of the hospitalisation data that identified possible case-patients that were not notified. Diagnostic or coding errors would most likely explain the additional measles hospitalisations identified among persons aged 65 years and over that were not notified.…”

Section: Discussionmentioning

confidence: 99%

“…As with previous national reports, 22,23 measles case notification rates and hospitalisation rates were almost double for Aboriginal people during the overall reporting period but was not found to be statistically significant. However in 2011, this differential increased, and Aboriginal persons had statistically significantly higher measles notification rates.Measles surveillance systems will not always identify every case of disease, 13,24 as evidenced by the retrospective identification of measles index cases in emergency department outbreaks 13,25,26 and through analysis of the hospitalisation data that identified possible case-patients that were not notified. Diagnostic or coding errors would most likely explain the additional measles hospitalisations identified among persons aged 65 years and over that were not notified.…”

mentioning

confidence: 99%

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EpiReview: Measles in NSW, 2002 - 2011

Rosewell¹,

Reinten-Reynolds²,

Spokes³

2012

NSW Public Health Bull.

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Measles has been eliminated in NSW for more than a decade; however outbreaks associated with international travel do occur. This EpiReview describes the epidemiology of measles in NSW from [2002][2003][2004][2005][2006][2007][2008][2009][2010][2011]. A total of 281 cases of measles were notified during the period, an average annual notification rate of 0.41 notifications per 100 000 population (range: 0.06-1.25). There were 139 hospitalisations recorded with a measles diagnosis in the 10-year reporting period, corresponding to a rate of 0.20 hospitalisations per 100 000 population. Of the 80 measles virus specimens genotyped, five genotypes were identified: D9 (38%), D8 (24%), D4 (16%), D5 (14%) with H1 identified less frequently (9%). No single genotype was associated with local transmission across successive years. To sustain good measles control, children should be vaccinated against measles on time through routine childhood immunisation, and all young adults who travel internationally should be vaccinated. Clinician awareness remains important in the early identification and control of measles to avoid further transmission during outbreaks and to enable the timely implementation of public health measures.Measles is an acute and highly contagious viral disease that is currently the most important cause of vaccinepreventable death globally. 1 Measles is rare in Australia with low rates of hospitalisation and death. 2 Measles is transmitted by airborne particles, droplets or fomites and humans are the only host of the measles virus. Common symptoms of measles include fever, rash, cough, coryza, conjunctivitis, diarrhoea and loss of appetite. Complications include ear infections, pneumonia, convulsions, croup, encephalitis and death. A milder illness is sometimes seen in vaccinated individuals, 3 and severe disease tends to occur in infants and malnourished persons. 1 Sub-acute sclerosing panencephalitis is a rare, delayed, fatal complication of measles virus infection.In Australia, measles-mumps-rubella (MMR) vaccines are scheduled as two doses for all children: the first at 12 months and the second at 4 years of age. 4 In 2013, the inclusion of measles-mumps-rubella-varicella vaccine (MMR-V) on the childhood immunisation schedule will bring forward the second measles dose to 18 months from 4 years. 5 In addition, documented immunity to measles has been a mandatory requirement for new health care workers in New South Wales (NSW) since 2007. In NSW, the percentage of children immunised with at least one dose of MMR at 2 years of age is 93.9%, 6 with some variation across local health districts (LHDs) and Aboriginal communities. 7 People at highest risk of measles infection include: infants aged less than 1 year (who are too young to be vaccinated); children aged 1-4 years who have received only a single dose of vaccine, especially if received late; and those born in the late 1960s to mid 1980s (who were neither infected with measles, nor vaccinated against it). 8Multiple lines of evidence suggest measl...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

EpiReview: Measles in NSW, 2002 - 2011

Rosewell¹,

Reinten-Reynolds²,

Spokes³

2012

NSW Public Health Bull.

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“…This is similar to a report of 17 locally acquired measles cases in NSW in 2011, where only six were diagnosed on their first contact with a health service; one case was diagnosed on sixth visit to a health facility and two were diagnosed retrospectively on review of emergency department triage notes five months later. 8 There have been only 237 measles cases over the last decade; therefore many Victorian medical practitioners would never have had first-hand experience with measles. Medical practitioners might not recognise clinical measles, including the non-specific prodromal symptoms before rash onset, and might be unaware of the requirement for immediate notification by telephone on suspicion of measles.…”

Section: Discussionmentioning

confidence: 99%

Challenges in managing a school‐based measles outbreak in Melbourne, Australia, 2014

Gibney

Brahmi²,

O'Hara³

et al. 2017

Australian and New Zealand Journal of Public Health

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Objective: To identify barriers to control of a Victorian primary school‐based measles outbreak. Methods: Confirmed measles cases notified in Victoria in 2014 were reviewed. Surveillance data, correspondence, and investigation notes for the school‐based outbreak were assessed regarding timeliness of diagnosis and notification, and adequacy of school‐based immunisation records. Results: Twenty‐three (31%) of the 75 measles cases notified in 2014 were school‐aged (5–18 years); three had documentation of measles vaccination, 17 were unvaccinated, and three had unknown vaccination history. Eight measles outbreaks were identified, including a primary school‐based outbreak with ten cases. Of the six unvaccinated pupils in the affected school, five (83%) contracted measles. The proportion of the school's prep students with documented vaccination records, as required by law, ranged from 39% in 2013 to 97% in 2014. Conclusions: Inadequately vaccinated students constitute a vulnerable population and schools are a potential site for measles outbreaks. Inadequate enforcement of school‐based immunisation records impact the management and control of school‐based measles outbreaks. Implications for Public Health: There is a need to educate clinicians on measles diagnosis and notification, and schools on the requirement to maintain up‐to‐date vaccination records. School entry is an opportunity to review student vaccination history and offer immunisations.

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“…65 It has been long known and recently reiterated that nonvaccinating patients pose a risk to others in the waiting room, especially infants who are not yet old enough to be vaccinated or individuals whose immune systems are compromised. 66,67 Physicians' dismissal of vaccine-refusing families runs counter to recommendations from the American Academy of Pediatrics (AAP) Committee on Bioethics. 68,69 The AAP stresses that health care providers should address vaccine refusal through hearing the family's concerns and discussing the risks that accompany not vaccinating one's child.…”

Section: Parents Who Refuse Vaccinesmentioning

confidence: 99%

Ethics and Childhood Vaccination Policy in the United States

et al. 2016

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Childhood immunization involves a balance between parents' autonomy in deciding whether to immunize their children and the benefits to public health from mandating vaccines. Ethical concerns about pediatric vaccination span several public health domains, including those of policymakers, clinicians, and other professionals.In light of ongoing developments and debates, we discuss several key ethical issues concerning childhood immunization in the United States and describe how they affect policy development and clinical practice. We focus on ethical considerations pertaining to herd immunity as a community good, vaccine communication, dismissal of vaccine-refusing families from practice, and vaccine mandates.Clinicians and policymakers need to consider the nature and timing of vaccine-related discussions and invoke deliberative approaches to policymaking. (Am J Public Health.

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Measles transmission in health care waiting rooms: implications for public health response

Cited by 28 publications

References 11 publications

EpiReview: Measles in NSW, 2002 - 2011

EpiReview: Measles in NSW, 2002 - 2011

Challenges in managing a school‐based measles outbreak in Melbourne, Australia, 2014

Ethics and Childhood Vaccination Policy in the United States

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