1666Transmission potential and operational costs for possible mumps virus exposure among immigration detainees
نویسندگان
چکیده
Background. On January 13, 2014 a previously healthy 43 year old male detainee who had been in custody for 323 days was evaluated for fever, unilateral parotid gland swelling and pain; he was referred to a local hospital given hemodynamic instability. In the hospital he was treated empirically for bacterial parotitis with intravenous vancomycin and was serologically evaluated for possible mumps virus infection. Methods. A commercial mumps virus IgM assay was positive for the case-patient which initiated clinical examination, cohorting and mumps serology testing of 105 individuals who were in the same detention dormitory or worked with the ill detainee during kitchen duty. Results. Among the 105 cohorted detainees, 12.4% (n = 13) were found to be susceptible to mumps; none were found to have clinical evidence of mumps. Medical staff spent an estimated 35 hours evaluating the cohort with an estimated laboratory cost of $2,400. Subsequent confirmatory testing by the Washington State Public Health Laboratory on the same initial serum specimen of the suspected index case was negative for mumps IgM while positive for mumps IgG, indicating that preliminary testing was a false positive. Conclusion. Our study indicates that immigration detention populations are vulnerable to mumps virus outbreaks given immunity levels below the threshold necessary to prevent transmission in a closed population. Initial submission of a salivary specimen for detection of mumps virus RNA as well as serum for mumps IgG could have excluded the diagnosis of mumps expeditiously, preventing the direct and opportunity costs noted above as well as unmeasured cost related to delays in custody operations and patient anxiety. Disclosures. All authors: No reported disclosures.
منابع مشابه
Life in Immigration Detention Centers An exploration of health of immigrant detainees in Sweden and three other EU member states
Puthoopparambil, S. J. 2016. Life in Immigration Detention Centers. An exploration of health of immigrant detainees in Sweden and three other EU member states. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1176. 96 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-554-9468-1. Governments around the world use immigration detention to detain and depo...
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