Limits...
Hospital preparedness in community measles outbreaks-challenges and recommendations for low-resource settings.

Shakoor S, Mir F, Zaidi AK, Zafar A - Emerg Health Threats J (2015)

Bottom Line: We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks.Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact.Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission within facilities.

View Article: PubMed Central - PubMed

Affiliation: Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.

ABSTRACT
We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks. The strategies that are more applicable to resource-poor settings, such as natural ventilation, mechanical ventilation with heating and air-conditioning systems allowing unidirectional air-flow, and protection of un-infected patients and healthcare workers (HCWs), have been examined. Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact. Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission within facilities.

Show MeSH

Related in: MedlinePlus

Measles reemergence in the world—community outbreaks 2009–2013 reported in PubMed. Gray areas show countries reporting outbreaks (≥1 measles outbreak) occurring between 2009 and 2013. Darker areas indicate large number of cases (>1,000 cases) reported by WHO in 2013, but no outbreaks reported in PubMed (English language) in the years 2009–2013.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4400300&req=5

Figure 0001: Measles reemergence in the world—community outbreaks 2009–2013 reported in PubMed. Gray areas show countries reporting outbreaks (≥1 measles outbreak) occurring between 2009 and 2013. Darker areas indicate large number of cases (>1,000 cases) reported by WHO in 2013, but no outbreaks reported in PubMed (English language) in the years 2009–2013.

Mentions: Figure 1 shows countries reporting measles outbreaks from 2009 to 2013 (5–19) and those reporting a high number of measles cases till May 2013 (20). Although outbreaks are distributed throughout the globe, most measles deaths are reported from low-income countries (21). Widespread community outbreaks in these regions result in high patient influx in tertiary care hospitals where over-crowding and breach in infection control practices leads to nosocomial spread. Although, Center for Disease Control's (CDC) Healthcare Infection Control Advisory Committee (HICPAC) have put forward definite recommendations for the isolation of measles cases in hospitals (22), these are not always easily applicable or feasible in resource-poor settings where ventilation systems in existing hospital structures range from natural to previously installed heating, ventilation, and air conditioning (HVAC) to complex hybrids of both. In most facilities, natural ventilation is the rule, with standard rooms and wards consisting of windows, doors, and ceiling fan(s), without HVAC or any ventilation ducts.


Hospital preparedness in community measles outbreaks-challenges and recommendations for low-resource settings.

Shakoor S, Mir F, Zaidi AK, Zafar A - Emerg Health Threats J (2015)

Measles reemergence in the world—community outbreaks 2009–2013 reported in PubMed. Gray areas show countries reporting outbreaks (≥1 measles outbreak) occurring between 2009 and 2013. Darker areas indicate large number of cases (>1,000 cases) reported by WHO in 2013, but no outbreaks reported in PubMed (English language) in the years 2009–2013.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400300&req=5

Figure 0001: Measles reemergence in the world—community outbreaks 2009–2013 reported in PubMed. Gray areas show countries reporting outbreaks (≥1 measles outbreak) occurring between 2009 and 2013. Darker areas indicate large number of cases (>1,000 cases) reported by WHO in 2013, but no outbreaks reported in PubMed (English language) in the years 2009–2013.
Mentions: Figure 1 shows countries reporting measles outbreaks from 2009 to 2013 (5–19) and those reporting a high number of measles cases till May 2013 (20). Although outbreaks are distributed throughout the globe, most measles deaths are reported from low-income countries (21). Widespread community outbreaks in these regions result in high patient influx in tertiary care hospitals where over-crowding and breach in infection control practices leads to nosocomial spread. Although, Center for Disease Control's (CDC) Healthcare Infection Control Advisory Committee (HICPAC) have put forward definite recommendations for the isolation of measles cases in hospitals (22), these are not always easily applicable or feasible in resource-poor settings where ventilation systems in existing hospital structures range from natural to previously installed heating, ventilation, and air conditioning (HVAC) to complex hybrids of both. In most facilities, natural ventilation is the rule, with standard rooms and wards consisting of windows, doors, and ceiling fan(s), without HVAC or any ventilation ducts.

Bottom Line: We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks.Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact.Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission within facilities.

View Article: PubMed Central - PubMed

Affiliation: Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.

ABSTRACT
We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks. The strategies that are more applicable to resource-poor settings, such as natural ventilation, mechanical ventilation with heating and air-conditioning systems allowing unidirectional air-flow, and protection of un-infected patients and healthcare workers (HCWs), have been examined. Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact. Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission within facilities.

Show MeSH
Related in: MedlinePlus