Measles Outbreak at a Privately Operated Detention Facility: Arizona, 2016.

Abstract

BACKGROUND:

We describe a measles outbreak and control measures implemented at a privately operated detention facility housing US Immigration and Customs Enforcement detainees in 2016.

METHODS:

Case-patients reported fever and rash and were either laboratory-confirmed or had an epidemiological link to a laboratory-confirmed case-patient. Immunoglobulin G (IgG) avidity and plaque reduction neutralization tests distinguished between primary acute and reinfection case-patients. Measles-specific IgG was measured to assess detainee immunity levels. We compared attack rates (ARs) among detainees and staff, between IgG-negative and IgG-positive detainees, and by detainee housing units and sexes.

RESULTS:

We identified 32 measles case-patients (23 detainees, 9 staff); rash onsets were during 6 May-26 June 2016. High IgG avidity and neutralizing-antibody titers >40000 to measles (indicating reinfection) were identified in 18 (95%) and 15 (84%) of 19 tested case-patients, respectively. Among 205 unit A detainees tested for presumptive immunity, 186 (91%) had detectable IgG. Overall, the AR was 1.65%. ARs were significantly higher among detainees in unit A (7.05%) compared with units B-F (0.59%), and among male (2.33%) compared with female detainees (0.38%); however, ARs were not significantly different between detainees and staff or between IgG-negative and IgG-positive detainees. Control measures included the vaccination of 1424 of 1425 detainees and 190 of 510 staff, immunity verification for 445 staff, case-patient isolation, and quarantine of affected units.

CONCLUSIONS:

Although ARs were low, measles outbreaks can occur in intense-exposure settings, despite a high population immunity, underscoring the importance of high vaccination coverage and containment in limiting measles transmission.

• Authors: Heather Venkat, Graham Briggs, Shane Brady, Ken Komatsu, Clancey Hill, Jessica Leung, Manisha Patel, Eugene Livar, Chia-Ping Su, Ahmed Kassem, Sun B Sowers, Sara Mercader, Paul A Rota, Diana Elson, Evan Timme, Susan Robinson, Kathryn Fitzpatrick, Jabette Franco, Carole Hickman, Paul A Gastañaduy
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 68 Issue 12 Pg. 2018-2025 (05 30 2019) ISSN: 1537-6591 [Electronic] United States
• PMID: 30256908 (Publication Type: Historical Article, Journal Article)
• Copyright: Published by Oxford University Press for the Infectious Diseases Society of America 2018.

Chemical References

• Immunoglobulin G
• Immunoglobulin M

Topics

• Adult
• Arizona (epidemiology)
• Disease Outbreaks
• Female
• History, 21st Century
• Humans
• Immunoenzyme Techniques
• Immunoglobulin G
• Immunoglobulin M
• Male
• Measles (diagnosis, epidemiology, history, prevention & control)
• Middle Aged
• Polymerase Chain Reaction
• Prisons
• Public Health Surveillance
• Serologic Tests
• Young Adult