Strategic directions for measles infection control in healthcare facilities (according to the analysis of the outbreak in a children hospital)


DOI: https://dx.doi.org/10.18565/epidem.2022.12.1.64-9

Davidova N.G., Golubkova A.A., Platonova T.A.

1) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 2) Moscow City Center for Hygiene and Epidemiology, Branch in the Eastern Moscow Administrative District, Moscow, Russia; 3) European Medical Center “UMMC-Health”, Yekaterinburg, Russia
Objective. To analyze the incidence of measles in a children hospital in order to define strategic directions for the control of the nosocomial spread of this infection.
Materials and methods. The investigators analyzed the 2007–2019 data available in the federal state statistical observation form No. 2 in Moscow and the Eastern Moscow Administrative District (EMAD), as well as epidemiological investigation of the Territorial Office of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being Directorate for the EMAD over 2017 and operational reports on case K, which had been submitted by the Moscow City Center for Hygiene and Epidemiology, Branch in the EMAD. Epidemiological and statistical studies were used.
Results. During the analyzed period, the incidence of measles in Moscow had two epidemic rises: from 2011 to 2015 and from 2017 to 2019. The situation in the EMAD generally corresponded to the development of the measles epidemic process in the metropolis. The increased incidence of measles in the EMAD in 2017 was found to be caused by its several local outbreaks in one of the children hospitals due to periodic infections in the nonspecialized units.A total of 47 people out of 228 contacts without information about vaccination from 5 sources of infection caught measles and fell ill. The average duration of contact from the onset of catarrhal phenomena in the source of infection was 2.8 days; the focal rate in the healthcare facility (HCF) was 50.0%; and the average number of cases in the focus was 5.7. Among the sick, the children aged 6 months to 1 year were 46.0%; those aged 1–2 years were 30.7%. The reasons for the spread of measles in the HCF were the low level of specific protection, late diagnosis, impairments in the anti-epidemic regime, and failure to take measures to ensure hospital environment hygiene.
Conclusion. To control the measles infection situation and to prevent the infection and spread in the HCF, it is necessary to achieve high measles vaccination coverage rates, efficiency in organizing anti-epidemic measures, examination and isolation of patients with symptoms of measles, alertness of medical personnel regarding the diagnosis of the disease, as well as constant monitoring of the situation on the territory of HCF dislocation.
Keywords: control strategies, healthcare facility, outbreak, measles
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About the Autors

Natalia G. Davidova, Graduate Student, Central Research Institute of Epidemiology, Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Epidemiologist, Moscow City Center for Hygiene and Epidemiology, Branch in the Eastern Moscow Administrative District, Moscow, Russia; dawidowa.nat2016@yandex.ru; https://orcid.org/0000-0003-4429-9844
Professor Alla A. Golubkova, MD; Leading Researcher, Laboratory of Healthcare-Associated Infections, Central Research Institute of Epidemiology, Federal Service for Supervision of Consumer Protection and Human Well-Being, Moscow, Russia; allagolubkova@yandex.ru; https://orcid.org/0000-0003-4812-2165 
Tatiana A. Platonova, Cand. Med. Sci., Head, Department of Epidemiology; Epidemiologist, European Medical Center «UMMC-Health»,Yekaterinburg, Russia; fill.1990@inbox.ru; https://orcid.org/0000-0001-5441-854X


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