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Article: Measles outbreak from Hong Kong International Airport to the hospital due to secondary vaccine failure in healthcare workers

TitleMeasles outbreak from Hong Kong International Airport to the hospital due to secondary vaccine failure in healthcare workers
Authors
Issue Date2019
PublisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=ICE
Citation
Infection Control & Hospital Epidemiology, 2019, v. 40 n. 12, p. 1407-1415 How to Cite?
AbstractObjective: To report an outbreak of measles with epidemiological link between Hong Kong International Airport (HKIA) and a hospital. Methods: Epidemiological investigations, patients’ measles serology, and phylogenetic analysis of the hemagglutinin (H) and nucleoprotein (N) genes of measles virus isolates were conducted. Results: In total, 29 HKIA staff of diverse ranks and working locations were infected with measles within 1 month. Significantly fewer affected staff had history of travel than non–HKIA-related measles patients [10 of 29 (34.5%) vs 28 of 35 (80%); P < .01]. Of 9 airport staff who could recall detailed exposure history, 6 (66.7%) had visited self-service food premises at HKIA during the incubation period, where food trays, as observed during the epidemiological field investigation, were not washed after use. Furthermore, 1 airport baggage handler who was admitted to hospital A before rash onset infected 2 healthcare workers (HCWs) known to have 2 doses of MMR vaccination with positive measles IgG and lower viral loads in respiratory specimens. Infections in these 2 HCWs warranted contact tracing of another 168 persons (97 patients and 71 HCWs). Phylogenetic comparison of H and N gene sequences confirmed the clonality of outbreak strains. Conclusion: Despite good herd immunity with overall seroprevalence of >95% against measles, major outbreaks of measles occurred among HKIA staff having daily contact with many international pssengers. Lessons from severe acute respiratory syndrome (SARS) and measles outbreaks suggested that an airport can be a strategic epidemic center. Pre-exanthem transmission of measles from airport staff to HCWs with secondary vaccine failure poses a grave challenge to hospital infection control.
Persistent Identifierhttp://hdl.handle.net/10722/289275
ISSN
2023 Impact Factor: 3.0
2023 SCImago Journal Rankings: 1.117
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCheng, VCC-
dc.contributor.authorWong, SC-
dc.contributor.authorWong, SCY-
dc.contributor.authorSridhar, S-
dc.contributor.authorChen, JHK-
dc.contributor.authorYip, CCY-
dc.contributor.authorHung, DLL-
dc.contributor.authorLi, X-
dc.contributor.authorChuang, VWM-
dc.contributor.authorTsang, OTY-
dc.contributor.authorWoo, GKS-
dc.contributor.authorChuang, SK-
dc.contributor.authorYuen, KY-
dc.date.accessioned2020-10-22T08:10:21Z-
dc.date.available2020-10-22T08:10:21Z-
dc.date.issued2019-
dc.identifier.citationInfection Control & Hospital Epidemiology, 2019, v. 40 n. 12, p. 1407-1415-
dc.identifier.issn0899-823X-
dc.identifier.urihttp://hdl.handle.net/10722/289275-
dc.description.abstractObjective: To report an outbreak of measles with epidemiological link between Hong Kong International Airport (HKIA) and a hospital. Methods: Epidemiological investigations, patients’ measles serology, and phylogenetic analysis of the hemagglutinin (H) and nucleoprotein (N) genes of measles virus isolates were conducted. Results: In total, 29 HKIA staff of diverse ranks and working locations were infected with measles within 1 month. Significantly fewer affected staff had history of travel than non–HKIA-related measles patients [10 of 29 (34.5%) vs 28 of 35 (80%); P < .01]. Of 9 airport staff who could recall detailed exposure history, 6 (66.7%) had visited self-service food premises at HKIA during the incubation period, where food trays, as observed during the epidemiological field investigation, were not washed after use. Furthermore, 1 airport baggage handler who was admitted to hospital A before rash onset infected 2 healthcare workers (HCWs) known to have 2 doses of MMR vaccination with positive measles IgG and lower viral loads in respiratory specimens. Infections in these 2 HCWs warranted contact tracing of another 168 persons (97 patients and 71 HCWs). Phylogenetic comparison of H and N gene sequences confirmed the clonality of outbreak strains. Conclusion: Despite good herd immunity with overall seroprevalence of >95% against measles, major outbreaks of measles occurred among HKIA staff having daily contact with many international pssengers. Lessons from severe acute respiratory syndrome (SARS) and measles outbreaks suggested that an airport can be a strategic epidemic center. Pre-exanthem transmission of measles from airport staff to HCWs with secondary vaccine failure poses a grave challenge to hospital infection control.-
dc.languageeng-
dc.publisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=ICE-
dc.relation.ispartofInfection Control & Hospital Epidemiology-
dc.titleMeasles outbreak from Hong Kong International Airport to the hospital due to secondary vaccine failure in healthcare workers-
dc.typeArticle-
dc.identifier.emailCheng, VCC: vcccheng@hkucc.hku.hk-
dc.identifier.emailWong, SC: shchwong@hku.hk-
dc.identifier.emailWong, SCY: wcy288@hku.hk-
dc.identifier.emailSridhar, S: sid8998@hku.hk-
dc.identifier.emailChen, JHK: jonchk@hku.hk-
dc.identifier.emailYip, CCY: yipcyril@hku.hk-
dc.identifier.emailHung, DLL: dh2552@hku.hk-
dc.identifier.emailLi, X: xinli@hku.hk-
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hk-
dc.identifier.authoritySridhar, S=rp02249-
dc.identifier.authorityYip, CCY=rp01721-
dc.identifier.authorityYuen, KY=rp00366-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1017/ice.2019.278-
dc.identifier.pmid31587686-
dc.identifier.scopuseid_2-s2.0-85073407364-
dc.identifier.hkuros317264-
dc.identifier.volume40-
dc.identifier.issue12-
dc.identifier.spage1407-
dc.identifier.epage1415-
dc.identifier.isiWOS:000511235500013-
dc.publisher.placeUnited States-
dc.identifier.issnl0899-823X-

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