Philadelphia measles outbreak has hospitals on alert after child was sent to day care despite quarantine instructions
At least eight people have been diagnosed with measles in an outbreak that started last month in the Philadelphia area. The most recent two cases were confirmed on Monday.
The outbreak began after a child who'd recently spent time in another country was admitted to the Children’s Hospital of Philadelphia (CHOP) with an infection, which was subsequently identified as measles. The Philadelphia Department of Public Health considers the case to be "imported" but did not say from where.
The disease then spread to three other people at CHOP, two of whom were already hospitalized there for other reasons.
Two of those infected at the hospital were a parent and child. The child had not been vaccinated and the parent was offered medication usually given to unvaccinated people that can prevent infection after exposure to measles, but refused it, the Philadelphia Inquirer first reported.
Despite quarantine instructions, the child was sent to day care on Dec. 20 and 21, the health department said.
Yeah it sucks the family ignored the quarantine orders, I agree. Maybe they should be held liable for that.
What concerns me more, and what we should be talking about, is that the kid shows up at the hospital and two other patients contact the disease. At the hospital.
Being at a hospital should not be a threat to ones health. This along with other hospital borne illness and the insane amount of preventable deaths from medical negligence should concern all of us.
Measles is incredibly infectious, it's why we eradicated it in the first place. Plus there are rules to follow in a hospital waiting room specifically designed to avoid that.
But it relies on people actually following rules, and we can assume someone that didn't vaccinate or follow quarantine procedure is not a big fan of following "meaningless" rules. And meaningless to them is any rule they don't understand. Unfortunately they actively try to understand as little as possible so no one can accuse them of being the very scariest word to them right now, "woke".
The most infectious we've encountered and recorded.
Waiting rooms are the worst. I'm so glad we finally have the technology to allow us to check in from home and completely avoid waiting rooms.
It's likely that this was probably an ER visit. That means they still would've had to wait in the ER waiting room in order of importance.
The ER staff make educated guesses of how important it is someone gets seen right now based on reported symptoms, reported recent travels, temperature, etc.. Then people get seen in order from (for lack of a better phrase) most likely to die right now to least likely. Sometimes, the ER waiting room staff get it wrong, sometimes the patient isn't entirely honest, and sometimes symptoms unexpectedly worsen or change while the patient is in the waiting room.
Another scenario: if this wasn't an ER visit but instead a scheduled hospital visit, they likely still would've had to wait. They could probably fill out the required forms online, but they probably still would've had to wait until a doctor was actually available to see them, which could take a while. Doctors are almost never on time for appointments, mainly because they can only roughly estimate how long each appointment will actually take, and that's arguably more true for hospitals than it is for your normal neighborhood doctor.
All that to say that, unfortunately, hospital waiting rooms typically aren't very avoidable.
My local US Hospital has check in online for ER visits and then wait in car to be told to come in. You can't always do that if you get brought in a ambulance but for a broken arm or leg you can check in online and wait in your car.
Ah, that's different from what I was thinking of, which was filling out the paperwork ahead of time online and then going in for your appointment on the day of.
Not without a total overhaul of the intake process and a redesign of the necessary infrastructure, at least. Controlled access, keeping patients separate, delays to change the air and sanitize each room before a new patient is admitted, etcetera.
It sounds both practical and doable to me, but also expensive.
It sounds like it wasn't obvious the first child had measles when they were admitted. The initial symptoms don't include the rash. Measles is uncommon here, and it's ludicrously infectious, well above flu or most other similar-appearing diseases.
https://www.cdc.gov/measles/symptoms/signs-symptoms.html
It also sounds like, as soon as they realized, the hospital tried to prevent the spread by giving medication to those exposed. This parent refused it.
Being in a place where sick people are is a threat to your health. Sick people go to the hospital. What do you think the hospital is for?
I ask that you rethink this direction.
Hospitals, and people who are trying to save lives, should not be held responsible for the negligence of the ignorant few.
They spend a lot of time, money, and training on preventing Hospital Acquired ID, but they can only prevent so much. Sometimes it's due to negligence, but they can't restrain a child in a waiting room, they can't stop 100℅ of spread. Without knowing the facts of the case (which they are surely reviewing), please don't jump to blame.
I wouldn't blame the hospitals themselves so much as the tradition of waiting room triage.
We shouldn't be concentrating a bunch of potentially-contaigous inpatients together at all, but remodeling the infrastructure to design around a more sterile intake process would be expensive.
Agreed. And wouldn't be considered expensive if there was a cap on profits.
Contrary to popular belief, the hospital is not a completely sanitary place.
Rather, it's a place they try their absolute hardest to keep as sanitary as possible because they don't want the healthy people (doctors, nurses, visitors, etc.) to get sick and because they don't want the sick people (patients) to get even more sick.
Germs can unfortunately slip through the cracks even if every procedure is followed to the letter. There are times where they break procedure either on purpose or by accident (and doctors and hospitals can be put on the hook, legally, for those times), but this doesn't seem to be one of those times given what we know right now.
The R naught (how many people a disease spreads to per infected person) on measles is insane; the average infected person can spread it to 12-18 people (source https://www.sciencenews.org/article/one-number-can-help-explain-why-measles-so-contagious)
Covid is like 1.2- 1.4 people per infected person. It left 1,000,000 Americans dead, which is about 416 Pearl Harbors or 333 9/11s.
The Spanish flu of 1918 killed multiple millions and, if memory serves, had an R naught of 2-3. Basically, our underfunded hospitals stand no chance against something so unbelievably infectious. Thank God we have a vaccine for it.