Johns Hopkins Center for Health Security and Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, 621 East Pratt Street, Suite, Baltimore, 210, USA.
BMC Public Health. 2021 Apr 13;21(1):620. doi: 10.1186/s12889-021-10652-9.
To understand operational challenges involved with responding to US measles outbreaks in 2017-19 and identify applicable lessons in order to inform preparedness and response operations for future outbreaks, particularly with respect to specific operational barriers and recommendations for outbreak responses among insular communities.
From August 2019 to January 2020, we conducted 11 telephone interviews with 18 participants representing state and local health departments and community health centers that responded to US measles outbreaks in 2017-19, with a focus on outbreaks among insular communities. We conducted qualitative, thematic coding to identify and characterize key operational challenges and lessons identified by the interviewees.
We categorized principal insights into 5 topic areas: scale of the response, vaccination operations, exclusion policies, community engagement, and countering anti-vaccine efforts. These topics address resource-intensive aspects of these outbreak responses, including personnel demands; guidance needed to support response operations and reduce transmission, such as excluding exposed or at-risk individuals from public spaces; operational challenges and barriers to vaccination and other response activities; and effectively engaging and educating affected populations, particularly with respect to insular and vulnerable communities.
Measles outbreak responses are resource intensive, which can quickly overwhelm existing public health capacities. Early and effective coordination with trusted leaders and organizations in affected communities, including to provide vaccination capacity and facilitate community engagement, can promote efficient response operations. The firsthand experiences of public health and healthcare personnel who responded to measles outbreaks, including among insular communities, provide evidence-based operational lessons that can inform future preparedness and response operations for outbreaks of highly transmissible diseases.
为了了解 2017-19 年美国麻疹疫情应对工作所面临的挑战，并从中汲取经验教训，以便为未来的疫情做好准备并做出应对，特别是在岛屿社区的疫情应对方面，有针对性地提出具体的应对操作障碍和建议。
2019 年 8 月至 2020 年 1 月，我们对 18 名参与 2017-19 年美国麻疹疫情应对工作的州和地方卫生部门以及社区卫生中心的代表进行了 11 次电话访谈，重点是岛屿社区的麻疹疫情。我们采用定性主题编码方法，识别并描述了受访者提出的关键操作挑战和经验教训。
我们将主要观点分为五个主题领域：应对规模、疫苗接种行动、排除政策、社区参与和对抗反疫苗工作。这些主题涉及这些疫情应对工作中资源密集型的方面，包括人员需求；支持应对行动和减少传播所需的指导，例如将暴露者或高危人员排除在公共场所之外；疫苗接种和其他应对活动的操作挑战和障碍；以及有效接触和教育受影响人群，特别是岛屿和脆弱社区。
麻疹疫情应对工作需要投入大量资源，这可能会迅速超出现有公共卫生能力。与受影响社区中值得信赖的领导人和组织进行早期和有效的协调，包括提供疫苗接种能力和促进社区参与，可以促进高效的应对行动。参与岛屿社区麻疹疫情应对工作的公共卫生和医疗保健人员的第一手经验提供了基于证据的操作经验教训，可以为未来高传染性疾病的疫情准备和应对工作提供参考。
