Transmission may occur:
(1) direct person-to-person contact
(2) airborne in a confined space
A suitable confined space may include:
(1) an automobile or bus
(2) an airplane
(3) a theater or enclosed stadium
(4) a waiting room in a physician’s office or Emergency Department
(5) a classroom or office
Factors associated with increased risk of becoming infected:
(1) direct, proximate contact for 20 minutes or more (Hope et al)
(2) sitting nearby (within 2 rows) for several hours
(3) baby in arm (Nelson et al)
(4) coughing by the index case
(5) air quality (warm air recirculation without filtration, low relative humidity) (Remington et al).
In a healthcare setting the infection may spread:
(1) from patient to healthcare worker
(2) from healthcare worker to healthcare worker
(3) from healthcare worker to patient
Since immunosuppression or immunodeficiency is associated with clinically severe measles, prevention of spread in a healthcare setting is very important.
