Three years ago, a 37-year-old Swiss traveler arrived at a Tucson, Ariz, emergency department with respiratory problems and a rash. Details of the case released today emphasize the high cost of measles more than a decade after the viral disease was eliminated in the United States.
An online account in the Journal of Infectious Diseases explains that the woman, who was not vaccinated against measles, was hospitalized on February 13, 2008, after she developed a fever during a brief trip to Mexico. Her measles diagnosis was not confirmed for a week. The case launched an outbreak of 363 suspected measles cases, 8 probable cases, and 14 confirmed cases in Tucson. Seven patients with confirmed measles were infected in health care settings, 6 in the same hospital. Four patients were hospitalized, 2 in intensive care units.
The outbreak response included records searches for 14 844 health care workers at 7 hospitals to document their immune status. About 15 000 work hours were lost to possible infection or sickness in health care personnel. Also, 4448 health care personnel at 7 hospitals were vaccinated immediately. Two hospitals involved in the outbreak spent $800 000 to contain the 7 infections transmitted within their walls.
Investigators from the US Centers for Disease Control and Prevention and state and local health departments said the cases constitute the largest health care–associated measles outbreak in the United States since 1989. All confirmed cases were in individuals who were not vaccinated.
In an editorial, Stephen Ostroff, MD, of the Pennsylvania Department of Health, said diagnosis and reporting of the initial case was too slow, contact tracing took too long, and documentation of health care workers’ immunizations was insufficient.
Ostroff said the report should “spur at least some health care systems, hospitals, and physicians’ offices to act wisely before they too are confronted with a case of measles in their facilities.”