{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:24:49Z","timestamp":1791246289096,"version":"4.1.0"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2019,10,7]],"date-time":"2019-10-07T00:00:00Z","timestamp":1570406400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X19002782_as1\"><jats:title>Objective:<\/jats:title><jats:p>To report an outbreak of measles with epidemiological link between Hong Kong International Airport (HKIA) and a hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19002782_as2\"><jats:title>Methods:<\/jats:title><jats:p>Epidemiological investigations, patients\u2019 measles serology, and phylogenetic analysis of the hemagglutinin (H) and nucleoprotein (N) genes of measles virus isolates were conducted.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19002782_as3\"><jats:title>Results:<\/jats:title><jats:p>In total, 29 HKIA staff of diverse ranks and working locations were infected with measles within 1 month. Significantly fewer affected staff had history of travel than non\u2013HKIA-related measles patients [10 of 29 (34.5%) vs 28 of 35 (80%);<jats:italic>P<\/jats:italic>&lt; .01]. Of 9 airport staff who could recall detailed exposure history, 6 (66.7%) had visited self-service food premises at HKIA during the incubation period, where food trays, as observed during the epidemiological field investigation, were not washed after use. Furthermore, 1 airport baggage handler who was admitted to hospital A before rash onset infected 2 healthcare workers (HCWs) known to have 2 doses of MMR vaccination with positive measles IgG and lower viral loads in respiratory specimens. Infections in these 2 HCWs warranted contact tracing of another 168 persons (97 patients and 71 HCWs). Phylogenetic comparison of H and N gene sequences confirmed the clonality of outbreak strains.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19002782_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>Despite good herd immunity with overall seroprevalence of &gt;95% against measles, major outbreaks of measles occurred among HKIA staff having daily contact with many international pssengers. Lessons from severe acute respiratory syndrome (SARS) and measles outbreaks suggested that an airport can be a strategic epidemic center. Pre-exanthem transmission of measles from airport staff to HCWs with secondary vaccine failure poses a grave challenge to hospital infection control.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2019.278","type":"journal-article","created":{"date-parts":[[2019,10,7]],"date-time":"2019-10-07T07:56:40Z","timestamp":1570435000000},"page":"1407-1415","source":"Crossref","is-referenced-by-count":20,"title":["Measles outbreak from Hong Kong International Airport to the hospital due to secondary vaccine failure in healthcare workers"],"prefix":"10.1017","volume":"40","author":[{"given":"Vincent C.C.","family":"Cheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuk-Ching","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally C.Y.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Sridhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.K.","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril C.Y.","family":"Yip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek L.L.","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivien W.M.","family":"Chuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen T.Y.","family":"Tsang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gibson K.S.","family":"Woo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuk-Kwan","family":"Chuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwok-Yung","family":"Yuen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,10,7]]},"reference":[{"key":"S0899823X19002782_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir065"},{"key":"S0899823X19002782_ref6","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2016.1271518"},{"key":"S0899823X19002782_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2013.08.016"},{"key":"S0899823X19002782_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2015.04.016"},{"key":"S0899823X19002782_ref13","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.05012-11"},{"key":"S0899823X19002782_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2018.11.016"},{"key":"S0899823X19002782_ref8","first-page":"679","article-title":"Notes from the field: measles transmission in an international airport at a domestic terminal gate\u2014April\u2013May 2014","volume":"64","author":"Banerjee","year":"2015","journal-title":"Morb Mortal Wkly Rep"},{"key":"S0899823X19002782_ref23","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1985.03350350068022"},{"key":"S0899823X19002782_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2009.09.009"},{"key":"S0899823X19002782_ref36","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268813002859"},{"key":"S0899823X19002782_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31463-0"},{"key":"S0899823X19002782_ref33","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1703309"},{"key":"S0899823X19002782_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2014.2"},{"key":"S0899823X19002782_ref4","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2019.24.17.1800529"},{"key":"S0899823X19002782_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2014.10.022"},{"key":"S0899823X19002782_ref2","unstructured":"2. 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