An expensive adult measles outbreak and response in office buildings during the era of accelerated measles elimination, Beijing, China

- First report of a measles outbreak in office buildings with outbreak-associated costs in China.
- Office buildings provided an environment that maintained an outbreak.
- Migrant workers from endemic areas could initiate measles outbreaks among local population.
- A single case must trigger outbreak responses regardless of the definition of an outbreak.
- Financial support by involved companies can provide needed resources for outbreak management.

BackgroundFew measles outbreaks among adults are reported in China, and outbreak response costs are seldom documented. We report an adult measles outbreak and response in 4 linked office buildings in Beijing and its associated costs.MethodThe World Health Organization measles case definitions were used to determine suspected and confirmed measles cases. Surveillance data were used to describe the outbreak, and records and interviews of response staff were used to describe the response. Costs were determined by use of retrospective surveys of cases, review of records, and interviews of staff.ResultsThe outbreak lasted 19 days, and involved 22 cases aged 23-49 years. Nineteen cases had a local household registration. All cases were employed by 8 companies in 4 linked office buildings. Among the 22 cases, 8 had temperature less than 38.5 degree, 18 had no Koplik spots and none had complications or hospitalizations. A total of 7930 contacts were identified, and of these, 6869 were employees in the office buildings. All the child contacts aged 8 months-14 years had been up-to-date for measles-containing vaccine (MCV); no adult could document their vaccination or measles history. Of contacts, about 96% were offered post-exposure vaccination. The total household costs were $13,298, or $605 per case. Control costs were $384,594, or $17,481 per case. Involved companies paid for 90.7% of control costs.ConclusionOffice buildings provide a mechanism for measles transmission. Timely control activities were challenged by the highly infectious nature of measles and mild presentations of cases. The outbreak response was very costly. Financial support by involved companies can provide needed resources for outbreak management.