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

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Venkat, Heather ; Briggs, Graham ; Brady, Shane ; Komatsu, Ken ; Hill, Clancey ; Leung, Jessica ; Patel, Manisha ; Livar, Eugene ; Su, Chia-ping ; Kassem, Ahmed ; Sowers, Sun B. ; Mercader, Sara ; Rota, Paul A. ; Elson, Diana ; Timme, Evan ; Robinson, Susan ; Fitzpatrick, Kathryn ; Franco, Jabette ; Hickman, Carole ; Gastañaduy, Paul A.
• 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 >40 000 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.
  
  
• Subjects:
  Article Detainee Measles Outbreak Reinfection Secondary Vaccine Failure
• Source:
  Clin Infect Dis. 68(12):2018-2025
• Pubmed ID:
  30256908
• Pubmed Central ID:
  PMC6435422
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States
• Volume:
  68
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:026acbf52f2328e67a99273d4ca830fe21eabaf10619d5f5daf150405687815c
• Download URL:
  https://stacks.cdc.gov/view/cdc/77014/cdc_77014_DS1.pdf
• File Type:
  [PDF - 370.46 KB ]