Measles Outbreak at a Privately Operated Detention Facility: Arizona, 2016

Details

• Personal Author:
  Brady S ; Briggs G ; Elson D ; Fitzpatrick K ; Franco J ; Gastañaduy PA ; Hickman C ; Hill C ; Kassem A ; Komatsu K ; Leung J ; Livar E ; Mercader S ; Patel M ; Robinson S ; Rota PA ; Sowers SB ; Su C-p ; Timme E ; Venkat H
• Description:
  BACKGROUND: We describe a measles outbreak and control measures implemented at a privately operated detention facility housing US Immigration and Customs Enforcement detainees in 2016. METHODS: Case-patients reported fever and rash and were either laboratory-confirmed or had an epidemiological link to a laboratory-confirmed case-patient. Immunoglobulin G (IgG) avidity and plaque reduction neutralization tests distinguished between primary acute and reinfection case-patients. Measles-specific IgG was measured to assess detainee immunity levels. We compared attack rates (ARs) among detainees and staff, between IgG-negative and IgG-positive detainees, and by detainee housing units and sexes. RESULTS: We identified 32 measles case-patients (23 detainees, 9 staff); rash onsets were during 6 May-26 June 2016. High IgG avidity and neutralizing-antibody titers >40000 to measles (indicating reinfection) were identified in 18 (95%) and 15 (84%) of 19 tested case-patients, respectively. Among 205 unit A detainees tested for presumptive immunity, 186 (91%) had detectable IgG. Overall, the AR was 1.65%. ARs were significantly higher among detainees in unit A (7.05%) compared with units B-F (0.59%), and among male (2.33%) compared with female detainees (0.38%); however, ARs were not significantly different between detainees and staff or between IgG-negative and IgG-positive detainees. Control measures included the vaccination of 1424 of 1425 detainees and 190 of 510 staff, immunity verification for 445 staff, case-patient isolation, and quarantine of affected units. CONCLUSIONS: Although ARs were low, measles outbreaks can occur in intense-exposure settings, despite a high population immunity, underscoring the importance of high vaccination coverage and containment in limiting measles transmission. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Emigration And Immigration Epidemiology Immune System Laboratories Men Occupational Exposure Occupational Health Public Health Safety Viral Diseases Women

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• Keywords:
  Author Keywords: Detainee Controlled Environment Disease Control Disease Transmission Employee Exposure Humans Immigrant Workers Immune System Infection Control Infectious Diseases Isolation Laboratory Testing Measles Medical Treatment Outbreak Policy Public Health Reinfection Secondary Vaccine Failure Skin Infections Statistical Analysis Surveillance-programs Vaccines Viral Diseases Viral Infections

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• ISSN:
  1058-4838
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Arizona ; District of Columbia ; Georgia ; Idaho ; Ohio ; OSHA Region 10 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  68
• Issue:
  12
• NIOSHTIC Number:
  nn:20056282
• Citation:
  Clin Infect Dis 2019 Jun; 68(12):2018-2025
• Contact Point Address:
  H. Venkat, Arizona Department of Health Services, Office of Infectious Disease Services, 150 N 18th Ave Office Suite 140, Phoenix, AZ 85007
• Email:
  hvenkat@cdc.gov
• Federal Fiscal Year:
  2019
• Peer Reviewed:
  True
• Source Full Name:
  Clinical Infectious Diseases
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:88ab83b3ff2d185975fb7e91078d26df8bc29c089f4aea4bf8e1b3e363cea9380892551166c3aaa6b283583a4924d3253c511292f910d456d4c4039b1dbf50ec
• Download URL:
  https://stacks.cdc.gov/view/cdc/213919/cdc_213919_DS1.pdf
• File Type:
  [PDF - 543.89 KB ]