Entry screening for measles at hospitals may reduce risk for exposure
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Key takeaways:
- A hospital in Seattle asked patients to self-screen for measles before entry.
- The screening program was easy to implement, researchers said.
SAN ANTONIO — A hospital in Seattle started a measles entry screening program for all visitors after an outbreak in the city, finding the measures were easy to put in place and deemed acceptable by patients, according to a study.
Measles transmission can occur up to 2 hours after a person has left a space, according to the CDC. Symptoms may not show up for 1 to 2 weeks, and 90% of susceptible people exposed to the virus will develop measles.
The CDC in January issued an alert to health care providers to be on the lookout for measles cases after a several outbreaks across the country, and measles cases rose globally by 20% in 2022.
Emily Brown, MPH, an infection preventionist at Seattle Children’s Hospital, said during a presentation at the Association for Professionals in Infection Control and Epidemiology annual meeting that the use of simple signs asking visitors about relevant symptoms and recent travel proved effective — and easier than contact tracing after infections have been discovered.
“The contact tracing aspect can be quite daunting, which becomes obvious when we look at what constitutes an infection,” Brown said. “Patient zero walks into the health care facility or perhaps another populated space, and now all others in the area without sufficient respiratory protection are also considered exposed.”
During two separate outbreaks in Seattle in 2019, Washington state health officials confirmed 90 cases, the most the state had seen in nearly 30 years.
In response, Seattle Children’s placed signs outside each of the hospital’s entrances asking patients to self-screen for symptoms and consider any travel they had taken before coming to the hospital.
After the outbreaks ended, infection prevention teams at the facility reviewed the screening signs to ensure they effectively and equitably communicated the importance that patients self-screen for measles. The teams used three iterations of signs, the last of which included the most common languages of the hospital’s patients — English, with a QR code to translate the sign into simplified Chinese, Somali, Spanish and Vietnamese.
The hospital also incorporated forms that listed measles symptoms, locations where exposure may have occurred and instructions for patients. Additionally, Brown said when potential measles-exposed patients attempted to enter the facility, specific entrances were set up for security to escort patients in while avoiding the potential for other patient exposures.
Brown told Healio that the screening program is relatively simple to put in place but that a full operational team plan, with an established phone line to reach the appropriate clinicians, is a key part of the program’s success.
“We are providing a framework for screening potential measles patients prior to entry, which is encouraged to be tailor-made to your patient’s population,” Brown said. “The signs and processes supporting it are equitable, accessible and sustainable. The plan offers an efficient way to identify potential cases prior to entry and the exposure of others ... and can be adapted to other pathogens as it requires minimal resources to implement and maintain.”
References:
- D’alo A, et al. EP 61. Presented at: APIC; June 3-5, 2024; San Antonio (hybrid).
- CDC. Measles (rubeola): About measles. https://www.cdc.gov/measles/about/index.html. Updated May 24, 2024. Accessed June 3, 2024.
- Measles 2019: Measles in Washington state. https://doh.wa.gov/you-and-your-family/illness-and-disease-z/measles/measles-2019. Accessed June 3, 2024.
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D’alo A, et al. EP 61. Presented at: APIC; June 3-5, 2024; San Antonio (hybrid).
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