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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

An example of a retractable hood over a patient to contain infectious exhaust particles from the patient. Such measures have not been applied practically, however, they hold potential for future use as an airborne or droplet infection control measure.
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Figure 0006: An example of a retractable hood over a patient to contain infectious exhaust particles from the patient. Such measures have not been applied practically, however, they hold potential for future use as an airborne or droplet infection control measure.

Mentions: An innovative alternative is personalized ventilation (PV) to reduce spread of measles to other hospital inpatients. PV involves restricting the ventilation system to one patient and employs high-speed air jets through an air-supply pillow or a retractable hood design (47). Figure 6 shows the retractable hood design. PV has however, not been shown to be practically effective in larger studies, and hood designs may not be acceptable to many pediatric patients and parents since they restrict activity and may compromise patient preferences. Moreover, the pillow design is also limited in that it requires the patient to be bed-bound. Although not feasible for integration into hospitals at this time, it is hoped that PV methods will improve in future and will be a welcome introduction in many EDs. Another important use for such systems may be when transporting patients with measles from one hospital area to another. A retractable hood attached to a mobile bed is ideal for such situations.


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)

An example of a retractable hood over a patient to contain infectious exhaust particles from the patient. Such measures have not been applied practically, however, they hold potential for future use as an airborne or droplet infection control measure.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0006: An example of a retractable hood over a patient to contain infectious exhaust particles from the patient. Such measures have not been applied practically, however, they hold potential for future use as an airborne or droplet infection control measure.
Mentions: An innovative alternative is personalized ventilation (PV) to reduce spread of measles to other hospital inpatients. PV involves restricting the ventilation system to one patient and employs high-speed air jets through an air-supply pillow or a retractable hood design (47). Figure 6 shows the retractable hood design. PV has however, not been shown to be practically effective in larger studies, and hood designs may not be acceptable to many pediatric patients and parents since they restrict activity and may compromise patient preferences. Moreover, the pillow design is also limited in that it requires the patient to be bed-bound. Although not feasible for integration into hospitals at this time, it is hoped that PV methods will improve in future and will be a welcome introduction in many EDs. Another important use for such systems may be when transporting patients with measles from one hospital area to another. A retractable hood attached to a mobile bed is ideal for such situations.

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