Measles Outbreak in a Pediatric Practice: Airborne Transmission in an Office Setting

Abstract

In February 1981, a measles outbreak occurred in a pediatric practice in DeKalb County, GA. The source case, a 12-year-old boy vaccinated against measles at 111/2 months of age, was in the office for one hour on the second day of rash, primarily in a single examining room. On examination, he was noted to be coughing vigorously. Seven secondary cases of measles occurred due to exposure in the office. Four children had transient contact with the source patient as he entered or exited through the waiting room; only one of the four had face-to-face contact within 1 m of the source patient. The three other children who contracted measles were never in the same room with the source patient; one of the three arrived at the office one hour after the source patient had left. The risk of measles for unvaccinated infants (attack rate 80%, 4/5) was 10.8 times the risk for vaccinated children (attack rate 7%, 2/27) (P = .022, Fisher exact test, two-tailed). Airflow studies demonstrated that droplet nuclei generated in the examining room used by the source patient were dispersed throughout the entire office suite. Airborne spread of measles from a vigorously coughing child was the most likely mode of transmission. The outbreak supports the fact that measles virus when it becomes airborne can survive at least one hour. The rarity of reports of similar outbreaks suggests that airborne spread is unusual. Modern office design with tight insulation and a substantial proportion of recirculated ventilation may predispose to airborne transmission.

Prevention of SARS-CoV-2 airborne transmission in a workplace based on CO2 sensor network

“…8 Furthermore, the probability of tuberculosis infection, for which airborne transmission is the established route of infection, is markedly reduced in workplaces with an ACH of 2 or higher. [14][15][16] The ACH at the time of the COVID-19 cluster outbreak was probably much lower than this. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint…”

“…8 Furthermore, the probability of tuberculosis infection, for which airborne transmission is the established route of infection, is markedly reduced in workplaces with an ACH of 2 or higher. [14][15][16] The ACH at the time of the COVID-19…”

A Systematic Literature Review of Indoor Air Disinfection Techniques for Airborne Bacterial Respiratory Pathogens

“…The pandemic has re-emphasised the importance of better understanding airborne transmission in COVID-19 but also for other pathogens. For example, other viruses of public health importance, including measles [7,8], can be spread by airborne transmission indoors [9][10][11][12]. Mycobacterium tuberculosis (M. tuberculosis) remains the leading infectious cause of death globally (1.4 million deaths in 2019), and airborne transmission has long been known as the dominant transmission mode of M. tuberculosis [13][14][15][16][17][18].…”

Modeling the Impact of Indoor Relative Humidity on the Infection Risk of Five Respiratory Airborne Viruses

“…Increasing scientific evidence provides support to the airborne transmission of respiratory infectious pathogens such as influenza (IV) [1][2][3][4][5][6] , measles (MeV) [7][8][9] and the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) [10][11][12][13][14][15][16][17][18] , all being enveloped viruses, while rhinovirus (RhV) 4,19 and human adenovirus (HAdV) 20,21 , both being non-enveloped. Airborne infections pose a threat to susceptible individuals whenever they inhale the infectious aerosols that can remain suspended for extended periods in confined indoor spaces or transported through the air 22,23 .…”