Imported Case of Measles (Rubeola); A Multiagency Mitigation Approach

Background: The ease of international air travels between countries continues to make infectious disease transmission across borders a challenge to public health agencies in the United States of Americas. This has also made it difficult to effectively and timely monitor, prevent and control communicable diseases.

Objectives:  1) Describe the steps taken in the investigation of an imported case of Measles (Rubeloa) into the Houston area. 2). Understand the potential dangers posed by ease and frequency of international travel to public health. 3) Importance of multiagency collaboration in prompt and timely investigation and intervention in responding to an infection like Measles (Rubeola). 4)  Importance of Real-time Outbreak and Disease Surveillance (RODS) system to actively monitor the occurrence of secondary cases.

Methods: This case study describes an imported case of measles with international air travel and arrival in the USA. Patient also had local air travel to the Houston, Texas area. An epidemiological investigation and follow-up was conducted

Results: The patient was a confirmed case of measles admitted to a local Houston hospital. However, it was not reported to the local health department until after his discharge from the hospital. An investigation undertaken immediately revealed that on discharge, the patient traveled to Florida. This prompted a very challenging multi-agency epidemiological investigation in order to track the patient and prevent further spread of the disease. Houston contacted numerous agencies and organization in an attempt to locate the patient. Organizations contacted included the local CDC quarantine station in Houston; surrounding area health departments; local providers; and Florida Health Department. Along with epidemiological investigation, appropriate intervention measures such as active surveillance and monitoring using Real-time Outbreak and Disease Surveillance (RODS) were implemented.  No secondary cases were identified.

Conclusions: Timely reporting, intervention and prompt response utilizing a multiagency cooperative approach allowed for adequate monitoring and effective surveillance.