Public health responses during measles outbreaks in elimination settings: Strategies and challenges

Abstract

In late September 2016, the Americas became the first region in the world to have eliminated endemic transmission of measles virus. Several other countries have also verified measles elimination, and countries in all six World Health Organization regions have adopted measles elimination goals. The public health strategies used to respond to measles outbreaks in elimination settings are thus becoming relevant to more countries. This review highlights the strategies used to limit measles spread in elimination settings: (1) assembly of an outbreak control committee; (2) isolation of measles cases while infectious; (3) exclusion and quarantining of individuals without evidence of immunity; (4) vaccination of susceptible individuals; (5) use of immunoglobulin to prevent measles in exposed susceptible high-risk persons; (6) and maintaining laboratory proficiency for confirmation of measles. Deciding on the extent of containment efforts should be based on the expected benefit of reactive interventions, balanced against the logistical challenges in implementing them.

Job Tension and Emotional Sensitivity to COVID-19 Public Messaging and Risk Perception

“…2 Small outbreaks of contagions, such as measles in the United States, normally are managed with a strategy of containment that is both physical and vaccine-basedisolating those infected while vaccinating those at risk. 3 Nonpharmaceutical interventions, commonly referred to as ''flattening the curve,'' take 2 main forms: suppression/ mitigation 4 and avoiding medical system overload to lower total deaths. 5 A mitigation strategy limits infection spread to a slowed and controlled rate, such as school closings, which slowed infection rates during the mitigation effort in Hong Kong's battle against the H1N1 pandemic in 2009.…”

Modeling and Controlling Epidemic Outbreaks: The Role of Population Size, Model Heterogeneity and Fast Response in the Case of Measles

“…The analyses of outbreak notifications and response data are a key part of an outbreak response [28] and modeling can help decision makers analyze different response strategies. Complex modeling is time intensive and thus often does not support the quick and ad-hoc decision making needed for an outbreak response.…”

Challenges in Public Health Rapid Response Team Management

“…12,13 Historically, RRTs or their equivalents have long been used in public health emergencies. [14][15][16][17] Despite this, to our knowledge, there has been no systematic or standardized guidance document on the establishment and management of a public health RRT workforce that is not limited to a particular disease. Thus, as countries and organizations have sought to develop and formalize their RRTs with the capacity to tackle a diversity of public health emergencies in alignment with IHR and the more recent GHSA initiative, a number of challenges have become apparent.…”