John Goldman had haven’t seen a case of measles in 30 years. But since April, the infectious disease specialist at the University of Pittsburgh Medical Center in central Pennsylvania has seen dozens of patients contract the disease.
“I never thought I’d see this come back,” he says.
Its health system, like others, has had to adapt to a new normal as measles returns to the United States. As the country’s caseload surpasses 3,600, the highest annual total since 1991, hospitals and health care providers are being forced to dust off decades-old protocols or develop new ones to deal with the highly contagious disease.
The University of Pittsburgh Medical Center Community Hospital in Lititz is in Lancaster County, the center of the current outbreak in Pennsylvania. He evaluated around fifty patients with measles, including around twenty requiring hospitalization. Statewide, Pennsylvania has recorded 943 cases, including 176 hospitalizations and five measles-related deaths as of September 30.
Goldman says Lititz Hospital quickly ramped up testing for measles, asking patients if they have symptoms such as fever, cough, sore throat, red eyes and whether they are vaccinated. The classic measles rash doesn’t appear until three to five days after these cold-like symptoms begin, or about one to two weeks after exposure to the virus.
The hospital asks doctors to call ahead before referring a patient with suspected measles to the emergency department. Patients must wear a mask and wait in the parking lot, where a staff member greets them and escorts them directly to a negative pressure room, bypassing the waiting area. These special isolation spaces have lower air pressure than exterior corridors, which traps airborne pathogens inside and prevents them from spreading within a hospital. Patients who do not have serious symptoms are asked to stay home.
“We’re really trying to prevent people from coming to the hospital with measles, because once they’re in the hospital, it’s very easy for them to expose other people,” Goldman says.
Jennifer Janco, chair of the pediatrics department at St. Luke’s University Health Network, which serves eastern Pennsylvania and New Jersey, says that with vaccination rates dropping and measles cases increasing across the country, “it was only a matter of time before we started seeing cases.”
St. Luke’s treated two unvaccinated siblings for measles in late July. One of the siblings was hospitalized at another health network but was released, and both were able to recover at home while pediatricians supervised their care remotely. The health network also tested other patients suspected of having measles.
Gn Health
