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Case Reports
. 1992 Dec;20(6):319-25.
doi: 10.1016/s0196-6553(05)80237-8.

Measles: Lessons From an Outbreak

Case Reports

Measles: Lessons From an Outbreak

I Gurevich et al. Am J Infect Control. .


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.

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