A survey of hospital infection control policies and employee measles cases during Los Angeles County's measles epidemic, 1987 to 1989.

BACKGROUND

Between December 1987 and December 1989, 74 adults employed in Los Angeles County acute care hospitals were found to have measles. To investigate measles infection control policies in Los Angeles County and to gain information on employee measles cases, two surveys were performed.

METHODS

A survey of all infection control practitioners (N = 102) of acute care hospitals was conducted in July 1989. Reported employee measles cases were surveyed after initial case reports were reviewed.

RESULTS

The survey of acute care hospitals revealed that only 17% had mandatory measles infection control policies requiring written proof of past measles vaccination, disease, or seropositivity. Only 4% of hospitals had policies affecting students or volunteers. A second survey of hospital employees with confirmed measles revealed that 46% (34/74) were working in hospitals without measles infection control policies, 43% (32/74) were born before 1957, and 31% (21/67) were working in jobs not traditionally considered to provide a high risk of measles exposure. One third of the sick employees were hospitalized. The standard of either birth date before 1957 or oral history of measles illness or vaccination would have classified 93% (39/42) of the employees with measles as immune.

CONCLUSIONS

Effective infection control policies against measles and rubella should be adopted and enforced. Those policies should only allow written documentation as proof of measles immunity and should address all employees, regardless of age or job description.