Measles Outbreak Forces Pennsylvania Hospitals to Revamp Infection-Control Protocols

John Goldman had never expected measles to return. After no confirmed outbreaks in the previous 30 years, infectious disease experts at the University of Pittsburgh Medical Center in central Pennsylvania have treated dozens of patients since April.

“I never thought this would come back,” he says.

Hospitals Adapt as Measles Cases Rise

As measles reemerged in the United States, health care systems have had to adapt to a new normal. The annual total is the highest since 1991, forcing hospitals and health care providers to replace decades-old protocols or develop new procedures for managing the highly contagious disease. CDC measles data tracks the latest reported cases.

The University of Pittsburgh Medical Center’s community hospital in Lititz is in Lancaster County, the epicenter of Pennsylvania’s current outbreak. Approximately 50 measles patients have been diagnosed there, and about 20 have required hospitalization. Across Pennsylvania, 943 confirmed cases had been recorded as of September 30. Of those patients, 176 were hospitalized, and five measles-related deaths were reported.

How Hospitals Screen and Isolate Suspected Measles Patients

Goldman said Lititz Hospital has rapidly expanded measles testing. Staff ask patients whether they have symptoms such as fever, cough, sore throat or red eyes and whether they have been vaccinated.

The characteristic measles rash typically appears three to five days after these cold-like symptoms begin, or about one to two weeks after exposure to the virus.

The hospital instructs doctors to call patients suspected of having measles before referring them to the emergency department. Patients must wear masks and wait in the parking lot, where staff meet them and take them directly to a negative-pressure room, bypassing the waiting room.

These isolation rooms have lower air pressure than surrounding hallways, helping contain airborne pathogens and prevent them from spreading throughout the hospital. Patients without serious symptoms are asked to remain at home.

“We’re really trying to prevent people from coming to the hospital with measles, because once you’re in the hospital, it’s very easy to infect others,” Goldman says.

Unvaccinated Children Recover at Home

With vaccination rates declining and measles cases increasing across the country, “it was only a matter of time before we started seeing cases,” said Jennifer Janko, director of pediatrics at St. Luke’s University Health Network, which serves eastern Pennsylvania and New Jersey.

St. Luke’s Hospital treated two unvaccinated brothers for measles in late July. One sibling had been admitted to another health network but was discharged. Both brothers recovered at home while a pediatrician oversaw their care remotely. The health network also tested other patients suspected of having measles.