Swift Isolation Protocol Shields Chicago Children’s Hospital During 2024 Measles Surge

Getting Ahead of Measles at APIC25

Measles is so contagious that a single cough can infect an unprotected bystander 2 hours later. Faced with that reality after Chicago confirmed an outbreak in March 2024, the infection prevention and control (IPC) team at a major pediatric hospital built a rapid-response framework that ultimately kept every inpatient, caregiver, and staff member measles-free.

The information was presented as a poster at the Association of Professionals in Infection Control and Epidemiology Conference and Expo, held in Phoenix, Arizona, from June 16 to 18, 2025. The presenting author was Nancy Luosang, MPH, CIC, from the Ann and Robert H. Lurie Children’s Hospital of Chicago. Coauthors were Matthew P. McHugh, MT(ASCP), MPH, CIC; Anna O’Donnell, MSN, RN, CIC, FAPIC; Larry Kociolek, MD, MSCI; and Ayelet Rosenthal, MD, MSc, all from Lurie Children’s Hospital of Chicago.

Nancy Luosang: "Our prompt implementation of infection prevention strategies successfully protected our patients and staff, resulting in zero healthcare-associated measles cases or exposures at our hospital. This framework can serve as a model for rapid containment and effective interdisciplinary collaboration in future outbreak responses."

The first step was speed. Within days of the city’s initial case, IPC and Clinical Excellence drafted a standard operating procedure (SOP) directing frontline teams to identify, isolate, and inform. Any child arriving with fever, rash, or exposure history triggered an immediate airborne-isolation order and real-time notification to IPC. The SOP was then adapted in partnership with the emergency department (ED), immediate-care clinics, transport services, and inpatient units so each could act on the algorithm without delay or confusion.

Because guidelines alone cannot keep pace with measles, the hospital layered frequent communication on top of written protocols. IPC held weekly virtual huddles with the city’s Department of Public Health to track community spread and update risk assessments. Parallel stakeholder meetings clarified unit-specific responsibilities and ensured scarce airborne rooms and N95 supplies were allocated where needed.

Education proved equally critical. Pocket cards, posters, and brief e-modules gave ED and urgent-care clinicians concise instructions on collecting nasopharyngeal swabs, administering weight-based vitamin A, and arranging post-exposure prophylaxis (PEP) for vulnerable contacts. Materials were revised as the outbreak evolved, sometimes twice in the same week, so bedside teams always worked from current guidance.

Between March and April 2024, Chicago documented 64 confirmed measles cases. Seventeen children meeting exposure criteria arrived at the hospital; all were masked and isolated on arrival. Eleven underwent testing, 8 were admitted, and 6 ultimately tested positive. Every confirmed patient received high-dose vitamin A, and 5 nonimmune children exposed at an outside facility received timely PEP. Crucially, no hospital-associated transmissions occurred, a result the authors attribute to rigorous adherence to the SOP and real-time data sharing.
“Lurie Children’s success in preventing a potentially lethal measles outbreak is a credit to its internal teams taking infection prevention seriously, and rejecting phony treatment claims and outside noise,” said APIC 2025 President Carol McLay, DrPH, MPH, RN, FAPIC, FSHEA, CIC. “With an ongoing measles outbreak, resulting in over 700 cases across multiple states, IPC programs should model Lurie’s precautions to prevent additional cases of measles,” McLay added.

The pediatric center has since packaged its SOP, educational handouts, and meeting cadence into a repeatable “toolkit.” Leaders note that the same algorithm can be retuned for varicella, pertussis, or any airborne threat that resurfaces in an urban setting. Their experience reinforces a simple lesson: when a virus spreads rapidly, infection preventionists and other healthcare providers must move quickly and align every department before the first patient even reaches triage.