RESUMO
INTRODUCTION: With the introduction of MMR vaccination in the childhood vaccination programme in 1987, measles in Denmark is now rare. However, sub-optimal vaccination coverage results in the accumulation of susceptibles and outbreaks may still occur. MATERIAL AND METHODS: Information from epidemiological investigations and experience gained from the management of measles cases in a children's ward in Aalborg Hospital are described. RESULTS: A nine-year-old child was admitted with a tentative diagnosis of travel associated clinical malaria. The patient was not isolated and information on possible exposure to measles was only obtained upon discharge. Laboratory confirmation was received ten days after admission. At this time, a previous close-contact patient was re-admitted with high grade fever. This second patient was isolated following laboratory confirmation, and other hospitalised children received passive immunization. A total of 24 cases were reported, of which 12 patients were infected whilst hospitalisation and 21 were unvaccinated against measles. DISCUSSION: In a sub-optimally immunized population the introduction of measles virus may cause an outbreak in a local setting including a hospital environment, with potential spread to other geographical areas and hospitals. Obtaining a history of possible exposure to childhood infections, irrespective of the vaccination status, becomes highly significant upon admission. In the case of measles a detailed travel history is essential.
