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Investigators use data from rideshare apps to search for measles cases
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ATLANTA — Public health officials in Oregon used data from two rideshare companies to search for people who had been exposed to riders with measles, investigators reported at the CDC’s Epidemic Intelligence Service, or EIS, conference.
The Oregon Health Authority (OHA) received a report on Aug. 10, 2018, that a person with an active case of measles had visited the state, and a secondary case was reported 10 days later. Both patients reported using rideshare services.
According to the CDC, measles virus can remain infectious in the air for up to 2 hours after an infected person coughs or sneezes. Driven by several outbreaks, the United States has recorded more than 700 cases of measles already in 2019 — the most in 25 years.
“In Oregon, we consider exposure to be any time spent indoors within 10 meters of a patient’s location and within 20 minutes of the patient having been there,” Steven I. Rekant, DVM, MPH, an EIS officer with the Oregon Public Health Authority, said during a presentation. “We typically think about these exposures happening inside buildings, but sharing time in a car definitely meets these criteria.”
According to Rekant and colleagues, local and state public health officials obtained pick-up and drop-off times and locations from both patients’ rideshare accounts and negotiated with two rideshare companies for the release of contact information for drivers and passengers using the same cars. Uber released the information after officials visited the company’s office, but Lyft required a letter demonstrating OHA’s legal authority to request the data, Rekant and colleagues reported.
Four days after confirming the trips made by the two riders with measles, Rekant and colleagues received information for 14 contacts, including nine drivers and five passengers. They determined the vaccination status of the individuals who were exposed to the virus and advised them to seek care if they experienced any symptoms. One Lyft driver who was incompletely vaccinated was advised to monitor himself for symptoms, which did not develop.
“The Lyft driver called us a few days later to say his account had been suspended,” Rekant said. “Apparently, the urgency of the request triggered Lyft to deem him a public health risk and they were waiting for us to tell them it was safe for him to drive. We told Lyft that he was always clear to drive, as we were concerned, and Lyft said his account would be promptly reinstated.”
The OHA was contacted by other drivers who were concerned about exposures, but they had not been exposed to either patient, as indicated by their ride details, Rekant and colleagues said.
According to Rekant, a Gallup poll conducted in 2018 found that 30% of Americans use a rideshare service, including 45% of people aged 18 to 29 years.
“There were no reported cases of measles in the 14 people exposed through ridesharing,” Rekant said. “We believe the high rate of vaccination among these 14 people was an essential factor in preventing additional cases.”
The information provided by the rideshare companies “proved essential” for contact tracing, Rekant and colleagues said.
“Since future traceback investigations will likely include a rideshare element, it is important to establish a relationship with these companies ahead of outbreaks,” Rekant said. “This will reduce delays in obtaining vital information. It will also limit misunderstandings. Ultimately, it will help us do better public health.” - by Marley Ghizzone
Reference:
Rekant SI, et al. Measles contact tracing in the ridesharing economy — Oregon, 2018. Presented at: Epidemic Intelligence Service conference; April 29-May 2, 2019; Atlanta.
Disclosures: The authors report no relevant financial disclosures.