Measles: lessons from an outbreak

Am J Infect Control. 1992 Dec;20(6):319-25. doi: 10.1016/s0196-6553(05)80237-8.


Background: Measles outbreaks continue to be a problem for infection control in hospitals--patients, personnel, and employee health service. Guidelines for measles outbreaks are not clear for medical personnel in the hospital.

Methods: Outbreak investigation in a university-affiliated teaching hospital.

Results: Four primary cases resulted in 607 staff exposures and two secondary cases. Forty-seven medical personnel were furloughed and 88 were vaccinated for measles. Minimal serologic criteria for immunity were found to be inadequate in the outbreak setting.

Conclusions: We found that serologic guidelines for assessing immunity to measles are inadequate. During the outbreak, we arbitrarily doubled the acceptable enzyme-linked immunosorbent assay titers that we would consider protective, > or = 2, to decrease the possibility of further secondary cases. Employees with enzyme-linked immunosorbent assay measles titers less than 2 and without a definite history of natural measles were revaccinated with a measles vaccine. This strategy takes advantage of the anamnestic response that revaccination would confer in persons with low antibody titer.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Antibodies, Viral / analysis
  • Disease Outbreaks*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Hospital Bed Capacity, 500 and over
  • Hospitals, University / standards*
  • Humans
  • Infection Control / methods
  • Male
  • Measles / epidemiology*
  • Measles / immunology
  • Measles / prevention & control
  • Measles / transmission
  • Measles Vaccine
  • New York / epidemiology
  • Personnel, Hospital / statistics & numerical data*
  • Vaccination


  • Antibodies, Viral
  • Measles Vaccine