At a hospital in Seattle, a measles entry screening program has been set up for all visitors in response to a city-wide outbreak. This initiative has been characterized as quick to enact and broadly accepted by patients, yielding significant results according to a recent study.
Measles, a disease capable of transmission up to 2 hours after an infected person has left a given area, poses an immense public health threat. The symptoms often remain undetectable for 1 to 2 weeks and approximately 90% of individuals vulnerable to the disease who are exposed to the virus will develop symptoms. The increase in measles cases globally by 20% in 2022 led the CDC to warn healthcare providers about potential outbreaks.
Emily Brown, an infection preventionist at Seattle Children’s Hospital, reported at an annual meeting of the Association for Professionals in Infection Control and Epidemiology that the placement of informative signage outside the hospital entrances, requesting visitors to disclose any relevant symptoms and recent travel, has been highly effective, proving to be an easier strategy than contact tracing post-infection.
The twin outbreaks in Seattle in 2019, which resulted in 90 confirmed cases and marked a 30-year high for the state, spurred Seattle Children’s Hospital into action. The hospital deployed signs asking patients and visitors to self-screen for symptoms and consider their recent travels prior to coming to the hospital. Once the outbreaks were over, infection prevention teams inspected the signage for its effectiveness, accessibility, and appropriateness in conveying the importance of self-screening for measles. The final set of signs was designed to accommodate the diverse linguistic communities of the hospital’s clientele – English, simplified Chinese, Somali, Spanish, and Vietnamese- with a QR code available for translation.
The hospital also utilized forms detailing measles symptoms, potential exposure locations, and patient instructions. In instances where potentially exposed patients attempted to enter the facility, specific entrances were set up to allow security personnel to escort patients in, while minimizing the possibility of exposing other patients.
The effectiveness of this screening program lies not just in its simplicity, but in the full-scale operational plan supporting it, including a dedicated phone line to contact relevant clinicians. The plan prioritizes the early identification of potential measles cases prior to their entry and thus prevents potential exposures to others. It has been lauded for its accessibility, sustainability, and feasibility of being adapted to other pathogens as it requires minimal resources to implement and maintain.