Nosocomial outbreaks--a potential threat to the elimination of measles?

A suspected nosocomial outbreak of measles among children in the largest hospital in Southern Africa is described. The outbreak occurred from June to August 1999. Due to geographic differences in the areas where the patients lived, it is unlikely they came into contact with measles in the community. In contrast, all but the first case was in the ward of origin when another child was present with clinical signs and symptoms of measles. All but the first child had subsequent laboratory confirmation of acute measles infection. This outbreak occurred after the launch of the measles elimination effort in South Africa. The implications of nosocomial transmission of measles on the elimination effort are discussed.