Delays in Seeking Care, a Major Cause of Costly 2013 NYC Measles Outbreak

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xposures in 11 health care facilities occurred because many case patients were not immediately placed into airborne isolation.
xposures in 11 health care facilities occurred because many case patients were not immediately placed into airborne isolation.

HealthDay News — Vaccine refusals and delays, particularly in young children, fueled a large measles outbreak following importation of a case into the United States, according to a study published online July 30 in JAMA Pediatrics.

Jennifer B. Rosen, M.D., from the New York City Department of Health and Mental Hygiene (DOHMH), and colleagues conducted an epidemiologic assessment and cost analysis in order to examine all outbreak-associated cases of measles among persons residing in New York City in 2013.

The researchers report that between March 13, 2013, and June 9, 2013, 58 persons in New York City (median age, 3 years) were identified as having measles. More than three-quarters of these individuals (78 percent) were unvaccinated due to parental refusal or intentional delay. Less than half of individuals (48 percent) visited a medical health care professional who suspected measles and reported the case to the DOHMH at the initial clinical suspicion. Exposures in 11 health care facilities occurred because many case patients were not immediately placed into airborne isolation, with a total of 3,351 exposed contacts identified. A total of 10,054 hours were spent responding to and controlling the outbreak, with a total direct cost to the New York City DOHMH of $394,448.

"Prompt recognition of measles along with rapid implementation of airborne isolation of individuals suspected of measles infection in health care facilities and timely reporting to public health agencies may avoid large numbers of exposures," the investigators write.

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