April 30, 2019— As the worst measles outbreak in decades continues, public health officials’ attention has focused on the importance of vaccinations to avoid spreading the disease.
Hospitals participating in 340B are among those responding to the outbreak. One such 340B hospital is Montefiore Nyack Hospital, a 375-bed acute care medical and surgical hospital in Rockland County, N.Y. Rockland County has been particularly affected by the measles outbreak. To date, the hospital has had 10 confirmed measles cases and has evaluated dozens of others for potential infections. Three patients have been admitted due to complications such as pneumonia.
The past six months have provided an unexpected problem for hospitals across the U.S. The Centers for Disease Control and Prevention (CDC) reports that as of April 29, more than 700 measles cases have been confirmed for 2019, the largest number of confirmed cases since the disease was declared eliminated in the U.S. in 2000. So far, 22 states have been affected, especially New York and Washington. As of late April, Rockland County reported more than 200 confirmed cases since the outbreak started there in October 2018.
The measles outbreak has presented a challenge for hospitals such as Montefiore Nyack, as measles is an extremely contagious disease. The virus can live for up to two hours in an airspace where an infected patient coughed or sneezed. This makes it crucial to isolate patients who are potential or confirmed cases. Montefiore Nyack has responded quickly to this by establishing isolation procedures for potential and confirmed patients.
“The isolation procedures are crucial,” said Jeffrey Rabrich, DO, Montefiore Nyack Hospital’s Emergency Room Director. “Coordinating closely with emergency medical services agencies through training helps us identify potential measles patients early, as there is possible exposure just from a potential patient walking into the emergency room.”
Dr. Rabrich and his colleagues are also focused on prevention for pregnant patients. The hospital uses its infusion center to provide prenatal clinic patients with intravenous immunoglobulin (IVIG) treatment to help give them the immunity they need. “Having the infusion center enables us to provide IVIG treatment as quickly as possible to the patient without disrupting their schedule,” Dr. Rabrich said.
The hospital also asks families of pediatric patients prior to discharge whether the patient has received the measles vaccine and offers to inoculate unvaccinated patients before they leave the hospital.
Montefiore Nyack Hospital has used 340B program savings to help provide numerous services, including an offsite prenatal clinic and an offsite infusion center, and to offset some of the charity care it provides its community. Nationwide, 340B hospitals are 52 percent more likely than non-340B hospitals to establish an immunization program, which can include measles vaccines and other crucial vaccinations for children.
Public health experts remain unsure exactly how long the measles outbreak will continue. Until it ends, 340B hospitals such as Montefiore Nyack Hospital stand ready to ensure that the patients who rely on them for care are receiving the protection and the treatment that they need.