Measles outbreaks in the United States : public health preparedness, control and response in healthcare settings and the community
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Measles outbreaks in the United States : public health preparedness, control and response in healthcare settings and the community

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      Wednesday, April 02, 2008, 20:55 EDT (8:55 PM EDT) CDCHAN-00273-2008-04-02-ADV-N A measles outbreak linked to an importation from Switzerland currently is ongoing in Arizona. The first case, with rash onset on February 12, 2008, occurred in an adult visitor from Switzerland who was hospitalized with measles and pneumonia. This hospital admission prompted verification of the measles immune status of approximately 1800 healthcare personnel and vaccination of those without evidence of immunity. Through March 31, 2008, nine confirmed cases have been reported to the Arizona Department of Health Services, and there are two suspected cases (one in a Colorado resident) and hundreds of contacts under investigation. The nine case-patients range in age from 10 months to 50 years. All but one were infected in healthcare settings, one of the five adult case-patients is a healthcare worker, and all cases were unvaccinated at the time of exposure. In January and February 2008, San Diego experienced an outbreak of 11 measles cases, with an additional casepatient who was exposed in San Diego but became ill in Hawaii. The index case was an unvaccinated child who had recently traveled to Switzerland, where a measles outbreak is ongoing (see http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a3.htm). Transmission in this outbreak occurred in a doctor's office as well as in community settings. Measles genotype D5 was identified from more than one case in the San Diego and Arizona outbreaks; this genotype is currently circulating in Switzerland (see http://www.eurosurveillance.org/edition/v13n08/080221_1.asp). Confirmed measles cases also have been reported from New York City (involving genotype D4, which is identical to the genotype responsible for a large ongoing measles outbreak in Israel; see http://www.eurosurveillance.org/edition/v13n08/080221_3.asp) and from Virginia (importation from India). In addition, two measles cases recently confirmed in unvaccinated siblings from Michigan may have resulted from exposure during a long stop-over in the Atlanta airport.
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