Geisinger Medical Center in Danville, Pennsylvania, has restricted visits to its neonatal intensive care unit after an exposed visitor tested positive for measles.
The hospital, located a two-and-a-half-hour drive outside Philadelphia, stated that the infected visitor was present inside the unit for four days from August 14 to August 17 before the diagnosis was confirmed. The visitor is no longer in the building, and health officials have not confirmed whether the virus spread to any infants or healthcare workers.
Under the temporary visitation policy enacted on Monday, August 24, only parents or legal guardians of patients are allowed to enter the unit. Visiting parents must show no signs or symptoms of measles and will be required to pass entrance screening before gaining entry.
The hospital is also highly encouraging permitted visitors to wear surgical masks while inside the facility. At present, Geisinger Medical Center is allowing no exemptions for vaccinated immediate family members, such as grandparents, to visit the unit.
The hospital announced the new restrictions on social media, where it turned off the public commenting feature on its post. Geisinger Medical Center was contacted for further details regarding the situation.
New visitation rules implemented at Geisinger Medical Center
Dr Michael Fitzpatrick, chief medical officer at Geisinger Medical Center, said entry screening was established to protect patients, staff, and visitors as regional case numbers increase.
"Our teams established entrance screenings to best protect our patients, visitors and staff as measles cases are rising in the area," Dr Fitzpatrick said. "The screening process relies on accurate and complete information being shared at the time of entry."
Dr Fitzpatrick added that hospital leadership carefully evaluated how the restrictions would affect families before introducing the policy.
"We understand how important it is for parents and immediate family members to be present with loved ones in the NICU, and we did not make this change in visitation policy lightly," Dr Fitzpatrick said. "We carefully considered the impact on families before determining that these temporary restrictions were necessary to protect our most vulnerable patients."
Surge in Pennsylvania measles cases and fatalities
The exposure occurs during a major surge in infections across Pennsylvania, which has recorded the third largest measles outbreak in the United States with 424 cases and two deaths. A total of 10 cases have been identified in the counties surrounding Montour County, where Danville is based.
The surrounding area is home to a large Amish and Mennonite population. Public health records note that these communities are historically less likely to receive vaccinations against measles and less likely to present themselves for clinical testing when sick.
Pennsylvania recorded two deaths linked to measles this week, marking the first measles fatalities in the United States this year and the first in the state in 35 years. Both fatalities occurred in Lancaster County, which remains the epicenter of the state outbreak.
High vulnerability of infants in neonatal care
A hospital neonatal intensive care unit (NICU) provides specialized, around-the-clock medical care for premature infants and severely ill newborns. Considered the sickest patients in any healthcare facility, these infants are too young to be vaccinated against measles or virtually any other infectious disease.
Infants in intensive care are at elevated risk from almost all diseases and frequently lack the protective antibodies passed from mothers shortly before birth. Consequently, hospitals regularly implement visitation limits during winter months and disease outbreaks to prevent pathogens from spreading to infants who may struggle to recover.
Similar visitation restrictions were introduced during the COVID-19 pandemic before being relaxed as pandemic concerns eased. While premature infants face higher risks of severe COVID-19 complications, coronavirus generally causes mild illness in young children and remains suspended in the air for about 20 minutes after an infected individual leaves.
Measles airborne risks and CDC vaccination advice
Measles is considered the most infectious disease known to science. Airborne measles particles remain active in the air for up to two hours after an infected person leaves an area, and the virus infects nine out of 10 unvaccinated individuals who are exposed.
Measles presents severe risks for children under five years old. Estimates indicate that one in 20 infected children requires hospitalization, one in 1,000 develops encephalitis or brain swelling, and up to three in every 1,000 die from the disease.
The Centers for Disease Control and Prevention recommends that children receive the MMR vaccine starting at 12 months of age. The CDC notes that a full two-dose vaccine regimen reduces the overall risk of measles infection by 97 percent.
Across the country, the United States is battling a widespread measles outbreak, recording 2,777 cases so far this year. This represents the highest annual number of measles infections recorded nationwide since 1991.
