Impact of a measles outbreak on a UK children's emergency department and the public health response: a retrospective observational study

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-08-11 DOI:10.1016/j.jhin.2025.07.020

C. Harris , C. Bird , M. Saavedra-Campos , C. Chatt , E. Booth , W. Proto , M. Patel

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引用次数: 0

Abstract

Background

Measles outbreaks create a significant burden for healthcare facilities. We describe the impact of a large outbreak between October 2023 and June 2024 on Birmingham Children's Hospital Emergency Department (ED) in terms of cases and contact-tracing workload.

Aim

To describe the impact of the outbreak in terms of case demographics, ED attendances, hospital admissions and post-exposure preventative measures.

Methods

Confirmed cases were defined as individuals presenting to hospital and with laboratory confirmation (measles PCR positive). Epidemiological, clinical and laboratory data from public health case management systems and hospital records were analysed.

Findings

A total of 366 patients attending ED were tested for measles. Of 161 confirmed cases, 40 (25%) were aged <1 year. Of 122 cases eligible for vaccination, 105 (86%) had no MMR vaccination. 32% (52/162) of confirmed cases attended ED more than once in the 21 days before being tested. Forty-six cases (29%) were admitted to hospital. Contacts were identified for 95 confirmed cases and 2397 exposure letters were sent. Thirteen confirmed cases had a symptom onset seven to 21 days after receiving an exposure letter.

Conclusion

The outbreak led to significant pressure on the children's hospital ED in terms of case burden and contact tracing, with the potential for nosocomial spread. Future outbreak response should focus on prompt implementation of infection prevention and control measures; clear and timely messaging around symptoms for both families and clinicians; streamlined notifications; accelerated development of measles point-of-care testing; access to pop-up vaccination in the community; and better integrated working between public health teams and frontline clinicians.

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麻疹疫情对英国儿童急诊科和公共卫生反应的影响：一项回顾性观察研究

背景：麻疹暴发给卫生保健机构造成了重大负担。我们描述了2023年10月至2024年6月期间伯明翰儿童医院（BCH）急诊科（ED）在病例和接触者追踪工作量方面的大型疫情的影响。目的：从病例统计、急诊科就诊率、住院率和接触后预防措施等方面描述疫情的影响。方法：确诊病例定义为到医院就诊并经实验室确诊（麻疹PCR阳性）的个体。分析了来自公共卫生病例管理系统和医院记录的流行病学、临床和实验室数据。结果：共有366名急诊科患者接受了麻疹检测。结论：疫情给儿童医院急诊科带来了病例负担和接触者追踪方面的巨大压力，具有院内传播的可能性。未来的疫情应对应侧重于迅速实施感染防控措施；为家庭和临床医生提供有关症状的明确和及时的信息；流线型的通知;加快麻疹即时检测的发展；在社区获得临时疫苗接种；更好地整合公共卫生团队和一线临床医生之间的工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.