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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.

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Related in: MedlinePlus

Creating a temporary AIIR room. Industrial-grade HEPA filter attached via a duct to sealed window. Arrows show clean air (supply into and exhaust from room). Ducts built-in for exhaust air must be sealed for the design to work.
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Figure 0005: Creating a temporary AIIR room. Industrial-grade HEPA filter attached via a duct to sealed window. Arrows show clean air (supply into and exhaust from room). Ducts built-in for exhaust air must be sealed for the design to work.

Mentions: A single room with ventilating duct may be modified to an AIIR attaching an industrial-grade (99.999% efficiency) HEPA filter via a connecting duct to an existing window. Similar models have been used by the EPA in evaluating HEPA filters in removing particulate air from rooms (41). Windows that are wider than the connecting duct exhaust port may be modified so the open area is sealed and supports the duct. This window may open to the outside or the hospital corridor with patient traffic, as discharged air is cleaned through the filter. Any other ducts which exhaust air to other rooms/wards or the outside should be sealed. The same HEPA filter will also create a negative pressure which will allow for air entry when the door opens. However, doors must be kept closed at most times and fresh air would then need to be introduced via a ceiling or side-wall duct. An anteroom for adjustment of airflow upon opening room doors is ideal. Figure 5 shows the temporary installation plan.


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)

Creating a temporary AIIR room. Industrial-grade HEPA filter attached via a duct to sealed window. Arrows show clean air (supply into and exhaust from room). Ducts built-in for exhaust air must be sealed for the design to work.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0005: Creating a temporary AIIR room. Industrial-grade HEPA filter attached via a duct to sealed window. Arrows show clean air (supply into and exhaust from room). Ducts built-in for exhaust air must be sealed for the design to work.
Mentions: A single room with ventilating duct may be modified to an AIIR attaching an industrial-grade (99.999% efficiency) HEPA filter via a connecting duct to an existing window. Similar models have been used by the EPA in evaluating HEPA filters in removing particulate air from rooms (41). Windows that are wider than the connecting duct exhaust port may be modified so the open area is sealed and supports the duct. This window may open to the outside or the hospital corridor with patient traffic, as discharged air is cleaned through the filter. Any other ducts which exhaust air to other rooms/wards or the outside should be sealed. The same HEPA filter will also create a negative pressure which will allow for air entry when the door opens. However, doors must be kept closed at most times and fresh air would then need to be introduced via a ceiling or side-wall duct. An anteroom for adjustment of airflow upon opening room doors is ideal. Figure 5 shows the temporary installation plan.

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