Outbreak

Last Friday at around 3:30 Lauren got called into a meeting and was asked if she wanted to take a field assignment to assist state and local health officials in Pennsylvania working to contain and explain a small outbreak of measles. Saturday she shipped off to a small town outside Pittsburgh to do what people do when they try to contain outbreaks.

You might think this involves huge numbers of infected people but an epidemic or outbreak is just anything above the normal rate of incidence. You also might expect quarantine, monkeys, spaces suits, overcrowded morgues, and Morgan Freeman but actually it's much less dramatic. One of Lauren's jobs, as I understand it is to track down anyone who may have come into contact with the infected people, particularly the first infected person; in this case a man from India. I think they try to track his movement and then let people know if they may have been in the same place and then if they've seen any symptoms to seek medical attention. Then they process samples from the infected patients and verify cases. It's one part detective work, one part accounting, one part robo-call, and, in Lauren's case, one part mixed martial arts.

It's easy to imagine how the task of tracking down everyone who came into contact with an infected person is a monumental task. Here's the list of what they're telling people about this PA case.

Exposures may have occurred at the following places and times:

• The Emergency Department of Children's Hospital of Pittsburgh of UPMC any time on March 10; between 8 p.m. March 21 and 11 a.m. March 22; between 6 p.m. March 25 and 5 a.m. March 26; between 6 p.m. March 27 and 3 a.m. March 28; and between 2:30 p.m. March 28 and 4 a.m. March 29.



• People also could have been exposed to measles anytime on March 23 at Children's Hospital's third floor Ear Nose and Throat and Specialty Clinics.



• Alle-Kiski Medical Center's Emergency Department, main lobby and ground floor public areas in Natrona Heights, between 10 a.m. and 3:30 p.m. March 28.



• During an EMS-1 Conference at Seven Springs Mountain Resort in Somerset and Fayette counties, exposure in the Snowflake Room and the main dining room might have occurred between 9:30 a.m. and 3:30 p.m. March 26.



• On the following Allegheny County Port Authority buses: Route 28X (Airport Flyer) between 10 a.m. and noon March 24 and between 2:30 p.m. and 4:30 p.m. March 28; 33X (West Busway all stops) between 10 a.m. and 1 p.m. March 27; and 71A between 11 a.m. and 1 p.m. March 24 and between 11 a.m. and 2 p.m. March 27.

AND the first patient could have come over on a plane with people that went to places all over the country. Add to that the fact that measles is an extremely contagious airborne agent and you have a high probability of transmission to others places and people. Add also that the man attended a conference of emergency health care professionals and your imagination can begin to run wild with shortfalls in the EMS departments around the region as their workers develop rashes and miss work for weeks at-a-time. In spite of all this hyperbole, you can start to see how important this one case might be. Even with high vaccination coverage, there was still transmission to other people. Luckily it looks like it's under control. Lauren can hopefully come home soon.

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