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Transcript
Quarantine and Isolation
During the Sedgwick County
Measles Outbreak, July 2014
Christine Steward, MPH
Epidemiologist
Sedgwick County Health Department
11/12/14
Source: Bunyen/Getty Images
Outline
What is measles?
Summary of the Sedgwick County outbreak
Measles control measures
Measles
Prodrome
2-4 days
Caused by measles virus
A.K.A. rubeola
Symptoms:
Fever
Cough, runny nose, eye infection
Tiredness
Koplik spots
Rash
Complications
30% of measles cases develop >1 complication
Pneumonia (1 in 20)
Ear infections (1 in 10)
Diarrhea (1 in 12.5)
Encephalitis (1 in 1,000)
Death (1-2 in 1,000)
Infection during pregnancy:
miscarriage, premature birth, low-birth-weight baby
Measles is Contagious
Incubation period: about 10 days
7-18 days from exposure to onset of fever
As long as 21 days
Communicable period: 1 day before the
beginning of prodrome to 4 days after rash
1
2
3
Fever, cough, etc.
4
5
Rash starts
6
7
8
9
Measles is Highly Infectious
Disease
Transmission
*R0
Measles
Airborne
12–18
Pertussis
Airborne droplet
12–17
Diphtheria
Saliva
6–7
Smallpox
Airborne droplet
5–7
Polio
Fecal-oral route
5–7
Rubella
Airborne droplet
5–7
Mumps
Airborne droplet
4–7
HIV
Sexual contact
2–5
SARS
Airborne droplet
2–5
Influenza
(1918 pandemic strain)
Airborne droplet
2–3
*The average number of secondary cases generated by a primary case at the onset of an epidemic in an entirely
susceptible population
Sedgwick County Outbreak
July 2014
Eleven confirmed cases of measles
4 children under 6 years old + 7 adults
Association with the Kansas City cases
Onset of Sedgwick Co. cases: 6/21 – 7/15
Two were unvaccinated
Three were too young to be vaccinated
Five had unknown vaccination status
One was vaccinated
General
Measles Control Measures
- Vaccinating on schedule
- Post-exposure
Vaccination within 72 hours of exposure
Immune globulin (IG) within 6 days of exposure
- Quarantine of exposed, susceptible
individuals for 21 days following last exposure
- Isolation for 4 days following onset of rash
Sedgwick County Measles:
Quarantine of Susceptible Contacts
Susceptible contacts:
- Three orders of quarantine were issued
•
•
Non-compliance
Travel ticket reimbursement
- Daily quarantine checks
Cases:
- Infectious until 4 days after rash onset.
Sedgwick County Health Dept.
Thank you