1. Quarantine and Isolation During the Sedgwick County
Measles Outbreak, July 2014
Christine Steward, MPH
Epidemiologist
Sedgwick County Health Department
11/12/14

2. Source: Bunyen/Getty Images

3. Outline What is measles? Summary of the Sedgwick County outbreak
Measles control measures

4. Measles Caused by measles virus A.K.A. rubeola Symptoms: Fever
Cough, runny nose, eye infection
Tiredness
Koplik spots
Rash
Prodrome
2-4 days

5. Complications 30% of measles cases develop >1 complication
Pneumonia (1 in 20)
Ear infections (1 in 10)
Diarrhea (1 in 12.5)
Encephalitis (1 in 1,000)
Death (1-2 in 1,000)
Infection during pregnancy:
miscarriage, premature birth, low-birth-weight baby

6. Measles is Contagious Incubation period: about 10 days
7-18 days from exposure to onset of fever
As long as 21 days
Communicable period: 1 day before the beginning of prodrome to 4 days after rash 1 2 3 4 5 6 7 8 9
Fever, cough, etc.
Rash starts

7. Measles is Highly Infectious
Disease
Transmission
*R0
Measles
Airborne
12–18
Pertussis
Airborne droplet
12–17
Diphtheria
Saliva
6–7
Smallpox
5–7
Polio
Fecal-oral route
Rubella
Mumps
4–7
HIV
Sexual contact
2–5
SARS
Influenza
(1918 pandemic strain)
2–3
*The average number of secondary cases generated by a primary case at the onset of an epidemic in an entirely susceptible population

8. Sedgwick County Outbreak
July 2014
Eleven confirmed cases of measles
4 children under 6 years old + 7 adults
Association with the Kansas City cases
Onset of Sedgwick Co. cases: 6/21 – 7/15
Two were unvaccinated
Three were too young to be vaccinated
Five had unknown vaccination status
One was vaccinated

9. Measles Control Measures
General
Measles Control Measures
- Vaccinating on schedule
- Post-exposure
Vaccination within 72 hours of exposure
Immune globulin (IG) within 6 days of exposure
- Quarantine of exposed, susceptible individuals for 21 days following last exposure
- Isolation for 4 days following onset of rash

10. Sedgwick County Measles: Quarantine of Susceptible Contacts
Three orders of quarantine were issued
Non-compliance
Travel ticket reimbursement
Daily quarantine checks
Cases:
Infectious until 4 days after rash onset.

11. Sedgwick County Health Dept.
Thank you