Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
1. Understand control measures necessary to limit disease spread in an unimmunized population.
2. Understand pre-outbreak policies needed to control disease outbreaks.

Background:
On May 27, 2007, Lane County Public Health received a report of a possible measles case admitted to a local hospital. The index case was unimmunized and had been infected in Japan prior ot traveling home.
Various challenges included:
1. Airline exposures.
2. Exposures among a community of unimmunized peers.
3. Delayed isolation of the index case at the hospital.
4. Shared ventilation among case's room and other hospital units.
5. Inappropriate discharge of case into community while still infectious.
6. Withholding of information and non-compliance with voluntary home isolation.
7. Limited documentation of measles immunity among health care workers.

Setting:
Mid-sized urban community (pop. 200,000).

Population:
Potential exposed persons on the airline flights between Japan and Oregon, the local hospital, grocery stores, restaurants, private parties, public concerts, and households of cases.

Project Description:
The presentation will describe the chronology of the events, from the initial discovery of the first case to the evolution of hospital and community-wide containment efforts designed to protect patients, staff-members and the general public.

Results/Lessons Learned:
The outbreak was successfully controlled, but the investigation identified potential for a much larger outbreak. The effective uses of quarantine and isolation during the outbreak underscore the utility of these public health tools in halting communicable disease tranmission. Maintenance of high rates of vaccination coverage, including improved strategiesof communication with persons who refuse vaccination, is necessary to prevent future outbreaks. The outbreak highlights the need for more targeted outreach and education for young adults and healthcare workers.