185 Workplace measles: risk analysis & maternity protection – a review of literature

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Abstract

Introduction

Measles is one of the most transmissible and highly communicable human infectious diseases known. It has a 90% secondary attack rate and the reproduction number is around 17. It is probably the most deadly of all childhood rash/fever illnesses. Since 2008 a rise in measles cases has been reported with outbreaks in 36 European countries.

Methods

A review of literature generated 85 articles of interest and were consulted for this review.

Result

Risk analysis shows that schools play a crucial role in the transmission chain of measles. At highest risk are infants under one year of age, adolescents and young adults. The risk is the highest in the part of the population that typically constitutes the engine of airborne transmission through social contacts at childcare, school, and within and between households. A catch-up campaign focusing all young adults and school personnel is necessary to achieve elimination in the short term. Health care workers (HCWs) are at substantially higher risk (2–13 times) than the general population for becoming infected with measles. Waning immunity in these HCWs will increase the risk of nosocomial infections. Nosocomial outbreaks are also exacerbated by atypical presentations of the disease.

Result

Pregnant women with measles had significantly higher risks of adverse maternal, fetal, and neonatal outcomes like sudden spontaneous abortions, stillbirth, early fetal death, and premature deliveries. Measles in pregnancy is complicated by a high maternal morbidity and mortality rate.

Discussion

To achieve ‘herd immunity’, more than 95% of the community must be vaccinated with 2 doses. For those unprotected, in doubt about clinical measles in anamnesis, in doubt about vaccination status or undocumented vaccination with 2 doses of measles containing vaccination, it is necessary to provide two doses with an interval of one month. Special focus on young adults among kindergarten, (pre)school personnel and HCWs is necessary.

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