Occupational Transmission of Measles Despite COVID-19 Precautions

To determine whether patient-to-doctor transmission of measles occurred in an emergency department (ED) despite isolation precautions and full personal protective equipment (PPE) during the COVID-19 pandemic, an epidemiological and molecular investigation was carried out following the identification...

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Main Authors: Gabriella De Carli, Emanuela Giombini, Alberto Colosi, Maria Concetta Fusco, Eleonora Lalle, Giulia Berno, Martina Rueca, Lavinia Fabeni, Licia Bordi, Fabrizio Maggi, Maurizio D’Amato, Valentina Vantaggio, Paola Scognamiglio, Francesco Vairo
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Pathogens
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Online Access:https://www.mdpi.com/2076-0817/14/6/519
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author Gabriella De Carli
Emanuela Giombini
Alberto Colosi
Maria Concetta Fusco
Eleonora Lalle
Giulia Berno
Martina Rueca
Lavinia Fabeni
Licia Bordi
Fabrizio Maggi
Maurizio D’Amato
Valentina Vantaggio
Paola Scognamiglio
Francesco Vairo
author_facet Gabriella De Carli
Emanuela Giombini
Alberto Colosi
Maria Concetta Fusco
Eleonora Lalle
Giulia Berno
Martina Rueca
Lavinia Fabeni
Licia Bordi
Fabrizio Maggi
Maurizio D’Amato
Valentina Vantaggio
Paola Scognamiglio
Francesco Vairo
author_sort Gabriella De Carli
collection DOAJ
description To determine whether patient-to-doctor transmission of measles occurred in an emergency department (ED) despite isolation precautions and full personal protective equipment (PPE) during the COVID-19 pandemic, an epidemiological and molecular investigation was carried out following the identification of two subsequent cases. The N fragment was used to identify the closest whole measles genome present in the GenBank nr database and, subsequently, this was used as a reference for the reconstruction of the entire MeV sequence in the two cases studied. Seven measles-susceptible healthcare workers were on duty the day of admission of the patient, wearing full PPE. The infected doctor neither visited the patient nor entered the isolation room. The patient wore a facial respirator. No breaches in infection control procedures, or other cases among contacts, patients and healthcare workers were identified. Molecular analysis provided evidence of patient-to-worker transmission: the two B3 genome sequences showed only one mutation and no sequences of other countries were identified as phylogenetically related. Isolation precautions and full PPE were widely implemented in the ED during the COVID-19 pandemic; however, this did not prevent nosocomial transmission of measles. Vaccination of healthcare workers and enhanced ventilation should complement other preventive measures to protect workers and patients.
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spelling doaj-art-d52719d8224a4af2bbfd96d32c6848352025-08-20T03:16:24ZengMDPI AGPathogens2076-08172025-05-0114651910.3390/pathogens14060519Occupational Transmission of Measles Despite COVID-19 PrecautionsGabriella De Carli0Emanuela Giombini1Alberto Colosi2Maria Concetta Fusco3Eleonora Lalle4Giulia Berno5Martina Rueca6Lavinia Fabeni7Licia Bordi8Fabrizio Maggi9Maurizio D’Amato10Valentina Vantaggio11Paola Scognamiglio12Francesco Vairo13Regional Service for Surveillance and Control of Infectious Diseases (SERESMI)—Lazio Region, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyLaboratory of Virology, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyDepartment of Prevention, Local Health Authority Roma 2, 00155 Rome, ItalyRegional Service for Surveillance and Control of Infectious Diseases (SERESMI)—Lazio Region, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyLaboratory of Virology, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyLaboratory of Virology, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyLaboratory of Virology, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyLaboratory of Virology, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyLaboratory of Virology, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyLaboratory of Virology, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyRegional Service for Surveillance and Control of Infectious Diseases (SERESMI)—Lazio Region, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyRegional Service for Surveillance and Control of Infectious Diseases (SERESMI)—Lazio Region, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyRegional Service for Surveillance and Control of Infectious Diseases (SERESMI)—Lazio Region, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyRegional Service for Surveillance and Control of Infectious Diseases (SERESMI)—Lazio Region, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, ItalyTo determine whether patient-to-doctor transmission of measles occurred in an emergency department (ED) despite isolation precautions and full personal protective equipment (PPE) during the COVID-19 pandemic, an epidemiological and molecular investigation was carried out following the identification of two subsequent cases. The N fragment was used to identify the closest whole measles genome present in the GenBank nr database and, subsequently, this was used as a reference for the reconstruction of the entire MeV sequence in the two cases studied. Seven measles-susceptible healthcare workers were on duty the day of admission of the patient, wearing full PPE. The infected doctor neither visited the patient nor entered the isolation room. The patient wore a facial respirator. No breaches in infection control procedures, or other cases among contacts, patients and healthcare workers were identified. Molecular analysis provided evidence of patient-to-worker transmission: the two B3 genome sequences showed only one mutation and no sequences of other countries were identified as phylogenetically related. Isolation precautions and full PPE were widely implemented in the ED during the COVID-19 pandemic; however, this did not prevent nosocomial transmission of measles. Vaccination of healthcare workers and enhanced ventilation should complement other preventive measures to protect workers and patients.https://www.mdpi.com/2076-0817/14/6/519measlesnosocomial transmissionhealthcare workersSARS-CoV-2molecular epidemiologyvaccination
spellingShingle Gabriella De Carli
Emanuela Giombini
Alberto Colosi
Maria Concetta Fusco
Eleonora Lalle
Giulia Berno
Martina Rueca
Lavinia Fabeni
Licia Bordi
Fabrizio Maggi
Maurizio D’Amato
Valentina Vantaggio
Paola Scognamiglio
Francesco Vairo
Occupational Transmission of Measles Despite COVID-19 Precautions
Pathogens
measles
nosocomial transmission
healthcare workers
SARS-CoV-2
molecular epidemiology
vaccination
title Occupational Transmission of Measles Despite COVID-19 Precautions
title_full Occupational Transmission of Measles Despite COVID-19 Precautions
title_fullStr Occupational Transmission of Measles Despite COVID-19 Precautions
title_full_unstemmed Occupational Transmission of Measles Despite COVID-19 Precautions
title_short Occupational Transmission of Measles Despite COVID-19 Precautions
title_sort occupational transmission of measles despite covid 19 precautions
topic measles
nosocomial transmission
healthcare workers
SARS-CoV-2
molecular epidemiology
vaccination
url https://www.mdpi.com/2076-0817/14/6/519
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