The changing epidemiology of measles in an era of elimination: lessons from health-care-setting transmissions of measles during an outbreak in New South Wales, Australia, 2012
The changing epidemiology of measles in an era of elimination: lessons from health-care-setting transmissions of measles during an outbreak in New South Wales, Australia, 2012
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Introduction: In countries where measles is rare, health-care-setting transmissions remain problematic.Australia experienced its largest measles outbreak in 15 years in 2012 with 199 cases reported nationally; 170 cases occurred in the state of New South Wales (NSW) with symptom onset between 7 April and 29 November 2012.Methods: A descriptive study was conducted using measles case data obtained from metropolitan Sydney local health districts in NSW in 2012.
Characteristics of measles source and secondary cases were described.Details of health-care camo iphone se case presentations resulting and not resulting in measles transmission were also analysed.Results: There were 168 confirmed and two probable cases resulting in 405 documented health-care presentations.
Thirty-four secondary cases acquired in health-care settings were identified, including 29 cases resulting from 14 source cases and 5 cases whose source could not be identified.Health-care-acquired cases accounted for 20% of all cases in this outbreak.Source cases were more likely to be of Pacific Islander descent (p = 0.
009) and to have had more presentations before diagnosis (p = 0.012) compared to other cases.The percentage of presentations to emergency departments was higher for presentations that resulted in transmission compared to those that did not (71.
4% and 37.6%, respectively, p = 0.028).
There were no significant differences between transmission and non-transmission presentations with respect to presence of rash and infection control measures (p = 0.762 and p = 0.221, respectively), although the power to detect these click here differences was limited.
Rash was reported at 66% of the presentations.Conclusion: Development of and adherence to protocols for the management of patients presenting to hospitals with fever and rash will minimize secondary transmission of measles.