Contact tracing of in-flight measles exposures: lessons from an outbreak investigation and case series, Australia, 2010
Contact tracing of in-flight measles exposures: lessons from an outbreak investigation and case series, Australia, 2010
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DOI：
10.5365/wpsar.2011.2.2.010
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发表时间：
2011-07-01
影响因子：
1
通讯作者：
Selveya, Christine E.
中科院分区：
文献类型：
--
作者：
Beard, Frank H.;Franklin, Lucinda J.;Selveya, Christine E.
目标。描述2010年澳大利亚爆发的9例麻疹病例，可能与一例指示病例有关，该病例是在感染期间从南非乘坐国际航班旅行的。根据澳大利亚公共卫生指南，维多利亚州、昆士兰州和新南威尔士州三个澳大利亚州卫生部门负责此次疫情的调查和管理。一名感染病例从南非乘飞机12小时抵达后，澳大利亚爆发了麻疹疫情。在途中接触索引病例的第一代病例中，只有一例位于澳大利亚和其他指南中建议进行接触者追踪的两行之内。后代人中的其余4例病例，包括两名卫生保健工作者，是在卫生保健环境中感染的。7例为青壮年。延误的诊断和通报阻碍了疾病控制和接触者追踪工作。在飞行中暴露于传染性麻疹病例后，需要审查当前的接触者追踪指南。替代策略可以包括将常规接触者追踪扩展到案例所在行两侧的两行之外，或者根据机舱布局和案例以及飞行中的案例和接触移动逐个扩展。通过新闻稿发布有关事件的信息，或者使用从相关航空公司获得的电子邮件或短信信息向航班上的每个人提供通用信息，也可能值得考虑。在消灭麻疹的时代，疾病输入、未充分接种疫苗的年轻人以及与保健有关的传播仍然是麻疹控制的挑战。
Objective. To describe a 2010 outbreak of nine cases of measles in Australia possibly linked to an index case who travelled on an international flight from South Africa while infectious.Methods. Three Australian state health departments, Victoria, Queensland and New South Wales, were responsible for the investigation and management of this outbreak, following Australian public health guidelines.Results. An outbreak of measles occurred in Australia after an infectious case arrived on a 12-hour flight from South Africa. Only one of four cases in the first generation exposed to the index case en route was sitting within the two rows recommended for contact tracing in Australian and other guidelines. The remaining four cases in subsequent generations, including two health care workers, were acquired in health care settings. Seven cases were young adults. Delays in diagnosis and notification hampered disease control and contact tracing efforts.Conclusion. Review of current contact tracing guidelines following in-flight exposure to an infectious measles case is required. Alternative strategies could include expanding routine contact tracing beyond the two rows on either side of the case's row or expansion on a case-by-case basis depending on cabin layout and case and contact movements in flight. Releasing information about the incident by press release or providing generic information to everyone on the flight using e-mail or text messaging information obtained from the relevant airline, may also be worthy of consideration. Disease importation, inadequately vaccinated young adults and health care-related transmission remain challenges for measles control in an elimination era.