Rapid communication Open Access


We describe a nosocomial outbreak of measles that occurred in an Italian hospital during the first months of 2017, involving 35 persons and including healthcare workers, support personnel working in the hospital, visitors and community contacts. Late diagnosis of the first case, support personnel not being promptly recognised as hospital workers and diffusion of the infection in the emergency department had a major role in sustaining this outbreak.


Article metrics loading...

Loading full text...

Full text loading...



  1. Italian Ministry of Health. Le coperture vaccinali dell’eta pediatrica. [Vaccination coverage in childhood]. Rome: Ministero della salute. [Accessed: July 2016}. Italian. Available from: http://www.salute.gov.it/imgs/C_17_tavole_20_allegati_iitemAllegati_3_fileAllegati_itemFile_3_file.pdf
  2. National Integrated Measles-Rubella Surveillance System. Measles in Italy: weekly bullettin. Week: 24-30 July 2017 (W30). Rome: Instituto Superiore di Sanita; 1 August 2017. Available from: http://www.epicentro.iss.it/problemi/morbillo/bollettino/Measles_WeeklyReport_N19eng.pdf
  3. European Commission. Commission Implementing Decision of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council. Off J Eur Union L. 2012;262:27. Available from: http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=uriserv:OJ.L_.2012.262.01.0001.01.ENG&toc=OJ:L:2012:262:TOC
  4. Lanini S, Capobianchi MR, Puro V, Filia A, Del Manso M, Karki T, et al. Measles outbreak on a cruise ship in the western Mediterranean, February 2014, preliminary report. Euro Surveill. 2014;19(10):20735.  https://doi.org/10.2807/1560-7917.ES2014.19.10.20735  PMID: 24650863 
  5. Grgič-Vitek M, Frelih T, Ucakar V, Fafangel M, Jordan Markocic O, Prosenc K, et al. An outbreak of measles associated with an international dog show in Slovenia, November 2014. Euro Surveill. 2015;20(3):21012.  https://doi.org/10.2807/1560-7917.ES2015.20.3.21012  PMID: 25635318 
  6. Jones G, Haeghebaert S, Merlin B, Antona D, Simon N, Elmouden M, et al. Measles outbreak in a refugee settlement in Calais, France: January to February 2016. Euro Surveill. 2016;21(11):30167.  https://doi.org/10.2807/1560-7917.ES.2016.21.11.30167  PMID: 27020578 
  7. George F, Valente J, Augusto GF, Silva AJ, Pereira N, Fernandes T, et al. Measles outbreak after 12 years without endemic transmission, Portugal, February to May 2017. Euro Surveill. 2017;22(23):30548.  https://doi.org/10.2807/1560-7917.ES.2017.22.23.30548  PMID: 28661392 
  8. Baxi R, Mytton OT, Abid M, Maduma-Butshe A, Iyer S, Ephraim A, et al. Outbreak report: nosocomial transmission of measles through an unvaccinated healthcare worker-implications for public health. J Public Health (Oxf). 2014;36(3):375-81.  https://doi.org/10.1093/pubmed/fdt096  PMID: 24099734 
  9. Maltezou HC, Wicker S. Measles in health-care settings. Am J Infect Control. 2013;41(7):661-3.  https://doi.org/10.1016/j.ajic.2012.09.017  PMID: 23352075 
  10. Botelho-Nevers E, Gautret P, Biellik R, Brouqui P. Nosocomial transmission of measles: an updated review. Vaccine. 2012;30(27):3996-4001.  https://doi.org/10.1016/j.vaccine.2012.04.023  PMID: 22521843 
  11. Filia A, Bella A, Cadeddu G, Milia MR, Del Manso M, Rota MC, et al. Extensive nosocomial transmission of measles originating in cruise ship passenger, Sardinia, Italy, 2014. Emerg Infect Dis. 2015;21(8):1444-6.  https://doi.org/10.3201/eid2108.141105  PMID: 26196266 
  12. Biellik RJ, Clements CJ. Strategies for minimizing nosocomial measles transmission. Bull World Health Organ. 1997;75(4):367-75. PMID: 9342896 
  13. Bowen AC, Ferson MJ, Palasanthiran P. Consequences of an unrecognized measles exposure in an emergency department. Emerg Med Australas. 2009;21(6):491-6.  https://doi.org/10.1111/j.1742-6723.2009.01230.x  PMID: 20002720 
  14. Orenstein WA, Perry RT, Halsey NA. The clinical significance of measles: a review. J Infect Dis. 2004;189 Suppl 1:S4-16. https://doi.org/10.1086/377712  PMID: 15106083 
  15. Moss WJ, Griffin DE. Measles. Lancet. 2012;379(9811):153-64.  https://doi.org/10.1016/S0140-6736(10)62352-5  PMID: 21855993 

Data & Media loading...

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error