Measles Outbreak among Institutional Infants after Hospital Infection

Park, Hyung Cheol; Park, Eun Young; Cho, Sun Hee; Choi, Young Jun; Ki, Hyun Kyun; Jung, Young Hwa; Moon, Kyung Rye; Ryu, So Yeon; Kim, Ki Soon

Abstract

PURPOSES: This study was to investigate the source of infection, mode of transmission and incidence of a measles outbreak among infants living in a Gwangju welfare institution in July 2000. METHODS: The information about 63 children was collected through the nurses interview and blood sampling and laryngopharyngeal swab were conducted to the children. In addition, an epidemiologic survey was performed to confirm the infection dissemination route. RESULTS: Before the outbreak, two children living at the institution were admitted to a university hospital for other health problems. These children shared a room with a 5 year old diagnosed with meningitis who was later diagnosed as having measles after rashes appeared. The two children developed measles after returning to their institution and the infection spread to other children in the institution. Among 63 children observed, 14 children(22.2%) developed measles, secondary attack rate of measles due to index cases was 19.7%. And 78.6% of the patients were between 4 and 8 months old. The room where the index case lived showed an attack rate of 81.8%, which is a much higher rate compared to other rooms. The attack rate among boys(26.0%) was higher than that of girls(12.5%), but it was not statistically significant. CONCLUSIONS: This outbreak was considered to be a nosocomial infection, where the index cases were admitted to a hospital, infected and the infection spread to children. Further studies are necessary to find out the maternal antibody levels of infants of post-vaccinated mothers and the optimal age for measles vaccination.