Beard Frank, Franklin Lucinda, Donohue Steven, Moran Rodney, Lambert Stephen, Maloney Marion, Humphreys Jan, Rotty Jessica, Martin Nicolee, Lyon Michael, Tran Thomas, Selvey Christine
Communicable Diseases Branch, Queensland Health, Brisbane, Queensland, Australia .
Western Pac Surveill Response J. 2011 Aug 25;2(3):25-33. doi: 10.5365/WPSAR.2011.2.2.010. Print 2011 Jul.
To describe a 2010 outbreak of nine cases of measles in Australia possibly linked to an index case who travelled on an international flight from South Africa while infectious.
Three Australian state health departments, Victoria, Queensland and New South Wales, were responsible for the investigation and management of this outbreak, following Australian public health guidelines.
An outbreak of measles occurred in Australia after an infectious case arrived on a 12-hour flight from South Africa. Only one of four cases in the first generation exposed to the index case en route was sitting within the two rows recommended for contact tracing in Australian and other guidelines. The remaining four cases in subsequent generations, including two health care workers, were acquired in health care settings. Seven cases were young adults. Delays in diagnosis and notification hampered disease control and contact tracing efforts.
Review of current contact tracing guidelines following in-flight exposure to an infectious measles case is required. Alternative strategies could include expanding routine contact tracing beyond the two rows on either side of the case's row or expansion on a case-by-case basis depending on cabin layout and case and contact movements in flight. Releasing information about the incident by press release or providing generic information to everyone on the flight using e-mail or text messaging information obtained from the relevant airline, may also be worthy of consideration. Disease importation, inadequately vaccinated young adults and health care-related transmission remain challenges for measles control in an elimination era.
描述2010年澳大利亚发生的9例麻疹疫情，此次疫情可能与一名索引病例有关，该病例在具有传染性时乘坐从南非出发的国际航班。
澳大利亚维多利亚州、昆士兰州和新南威尔士州的三个州卫生部门按照澳大利亚公共卫生指南负责此次疫情的调查和管理。
一名具有传染性的病例乘坐从南非出发的12小时航班抵达澳大利亚后，该国发生了麻疹疫情。在旅途中接触索引病例的第一代病例中，只有4例中的1例坐在澳大利亚及其他指南中建议进行接触者追踪的两排座位范围内。后续几代中的其余4例病例，包括2名医护人员，是在医疗机构感染的。7例病例为年轻成年人。诊断和报告的延迟阻碍了疾病控制和接触者追踪工作。
需要对当前在飞行途中接触感染性麻疹病例后的接触者追踪指南进行审查。替代策略可包括将常规接触者追踪范围扩大到病例所在排两侧两排以外，或根据机舱布局以及飞行中病例和接触者的活动情况逐案扩大追踪范围。通过新闻稿发布事件信息，或使用从相关航空公司获得的电子邮件或短信信息向航班上的每个人提供一般信息，也可能值得考虑。在消除麻疹的时代，疾病输入、疫苗接种不足的年轻成年人以及与医疗保健相关的传播仍然是麻疹控制面临的挑战。
