Measles Is Forcing Hospitals to Adapt to a New Normal
Measles Is Forcing Hospitals to Adapt to a New Normal
麻疹迫使医院适应“新常态”
John Goldman had not seen a case of measles in 30 years. But since April, the infectious disease specialist with the University of Pittsburgh Medical Center in central Pennsylvania has had dozens of patients come down with the disease. “I never thought I would see this come back,” he says. 约翰·戈德曼（John Goldman）已经有30年没见过麻疹病例了。但自今年4月以来，这位宾夕法尼亚州中部匹兹堡大学医学中心的传染病专家已经接诊了数十名患有该病的患者。他说：“我从未想过会看到这种疾病卷土重来。”
His health system, like others, has had to adapt to a new normal as measles makes a comeback in the United States. As the country’s cases top 3,600, the highest yearly total since 1991, hospitals and health care providers are being forced to dust off decades-old protocols or develop new ones to deal with the highly contagious disease. 随着麻疹在美国卷土重来，他的医疗系统和其他机构一样，不得不适应一种“新常态”。目前美国麻疹病例已超过3600例，创下1991年以来的年度最高纪录，医院和医疗服务提供者被迫重新启用尘封数十年的规程，或制定新的方案来应对这种高传染性疾病。
The University of Pittsburgh Medical Center’s community hospital in Lititz is in Lancaster County, the center of Pennsylvania’s current outbreak. It has evaluated around 50 patients with measles, with roughly 20 of those requiring hospitalization. Statewide, Pennsylvania has recorded 943 cases, including 176 hospitalizations and five measles-related deaths as of September 30. 匹兹堡大学医学中心位于利蒂茨（Lititz）的社区医院地处兰开斯特县，这里是宾夕法尼亚州当前疫情的中心。该院已评估了约50名麻疹患者，其中约20人需要住院治疗。截至9月30日，宾夕法尼亚州全州已记录了943例病例，包括176例住院治疗和5例与麻疹相关的死亡病例。
Goldman says the Lititz hospital has rapidly ramped up measles screening, asking patients if they are experiencing symptoms such as fever, cough, sore throat, red eyes, and whether they are vaccinated. The classic measles rash does not appear until three to five days after these cold-like symptoms begin, or about one to two weeks after exposure to the virus. 戈德曼表示，利蒂茨医院已迅速加强了麻疹筛查，询问患者是否出现发烧、咳嗽、喉咙痛、红眼等症状，以及是否接种过疫苗。典型的麻疹皮疹通常在这些感冒样症状开始后的三到五天内，或接触病毒后的一到两周内才会出现。
The hospital is instructing physicians to call ahead before referring a patient with suspected measles to the emergency department. Patients must wear a mask and wait in the parking lot, where a staff member meets them and escorts them directly to a negative-pressure room, bypassing the waiting area. These special isolation spaces have lower air pressure than outside hallways, which traps airborne pathogens inside and prevents them from spreading within a hospital. Patients who don’t have serious symptoms are asked to stay at home. 医院指示医生在将疑似麻疹患者转诊至急诊科之前必须提前致电。患者必须佩戴口罩并在停车场等候，由工作人员接应并直接护送至负压病房，避开候诊区。这些特殊的隔离空间气压低于外部走廊，能将空气传播的病原体困在室内，防止其在医院内扩散。症状不严重的患者则被要求居家隔离。
“We are really trying to prevent people from coming to the hospital with measles, because once they’re in the hospital, it’s very easy for them to expose other people,” Goldman says. “我们确实在努力防止人们带着麻疹来医院，因为一旦他们进入医院，就很容易传染给其他人，”戈德曼说。
Jennifer Janco, chair of pediatrics for St. Luke’s University Health Network, which serves eastern Pennsylvania and New Jersey, says that with falling vaccination rates and increasing measles cases around the country, “it was only a matter of time before we started seeing cases.” 服务于宾夕法尼亚州东部和新泽西州的圣卢克大学医疗网络（St. Luke’s University Health Network）儿科主任詹妮弗·扬科（Jennifer Janco）表示，随着疫苗接种率下降和全国麻疹病例增加，“我们开始看到病例只是时间问题。”
St. Luke’s treated two unvaccinated siblings for measles in late July. One of the siblings was hospitalized in a different health network but released, and both were able to recover at home while pediatricians oversaw their care remotely. The health network has also tested other patients suspected of having measles. 7月下旬，圣卢克医院治疗了两名未接种疫苗的麻疹患儿（兄妹）。其中一人曾在另一家医疗网络住院后出院，两人均在家中康复，儿科医生通过远程方式监督他们的护理。该医疗网络还对其他疑似麻疹患者进行了检测。
To prepare for possible measles cases, Janco says the health system stocked up on the measles, mumps, and rubella (MMR) vaccine, as well as immune globulin, a mix of antibodies derived from healthy human blood plasma. The MMR vaccine can prevent infection or make the illness milder if given within 72 hours of initial measles exposure for people who haven’t been vaccinated, and immune globulin can be given up to six days after exposure to help ease symptoms. 为了应对可能的麻疹病例，扬科表示，该医疗系统储备了麻疹、腮腺炎和风疹（MMR）疫苗，以及从健康人血浆中提取的抗体混合物——免疫球蛋白。对于未接种疫苗的人，在首次接触麻疹病毒后的72小时内接种MMR疫苗可以预防感染或减轻病情；而免疫球蛋白可在接触后6天内使用，以帮助缓解症状。
Deploying those interventions requires quick, accurate testing. Because measles was rare for so long, most hospitals do not have the ability to test in-house for the disease. Instead, a nasal or throat swab is collected and sent to a commercial or state public health laboratory. The turnaround time for results is one to three days. 部署这些干预措施需要快速、准确的检测。由于麻疹长期以来非常罕见，大多数医院没有能力在院内进行检测。取而代之的是，采集鼻拭子或咽拭子并送往商业或州公共卫生实验室。结果的周转时间为一到三天。
“There’s a narrow window of time to offer prevention for exposed, vulnerable people,” Janco says. “为接触过病毒的易感人群提供预防措施的时间窗口非常短，”扬科说。
Janco says in cases where measles is highly likely—for example, if the patient is unvaccinated and had exposure to an infected person—the Pennsylvania Department of Health will send a representative to collect a patient sample at their home. In other instances, patients have been asked to wait in their car in the parking lot, where a health care provider meets them and collects a sample to avoid exposing others. 扬科表示，在麻疹可能性极高的情况下——例如患者未接种疫苗且接触过感染者——宾夕法尼亚州卫生部会派代表到患者家中采集样本。在其他情况下，患者会被要求在停车场的车内等候，由医护人员前往采集样本，以避免传染他人。
When measles cases began appearing in Spartanburg County, South Carolina, last fall, staff at Prisma Health in nearby Greenville started discussing how they would handle measles cases if the outbreak got bigger. 去年秋天，当南卡罗来纳州斯帕坦堡县（Spartanburg County）开始出现麻疹病例时，附近格林维尔（Greenville）的Prisma Health员工开始讨论如果疫情扩大，他们将如何处理麻疹病例。
“Since Covid, we haven’t really had to think a lot about how we flow patients through a system, or the special things that we need to have in place to really protect not only the health care givers but also the other patients who are susceptible,” says Robin LaCroix, a pediatric infectious disease physician at Prisma Health. “自新冠疫情以来，我们确实不需要过多考虑如何优化患者在系统中的流动，或者需要采取哪些特殊措施来真正保护医护人员以及其他易感患者，”Prisma Health的儿科传染病医生罗宾·拉克鲁瓦（Robin LaCroix）说。
But the planning proved prescient: A total of 997 cases from October 2025 through March 2026 were tied to an outbreak centered around Spartanburg County and the upstate region in South Carolina. 但事实证明，这一规划具有先见之明：从2025年10月到2026年3月，共有997例病例与以斯帕坦堡县和南卡罗来纳州北部地区为中心的疫情有关。
Newborns are among the most susceptible to measles, since babies don’t usually receive their first dose of the MMR vaccine until 12 months of age. To protect them, the health system asked parents with newborns to call their pediatrician’s office when they arrived for an appointment and enter through a separate door so they didn’t have to sit in a waiting room. 新生儿是麻疹最易感的群体之一，因为婴儿通常要到12个月大时才会接种第一剂MMR疫苗。为了保护他们，该医疗系统要求新生儿父母在到达预约地点时致电儿科医生办公室，并从单独的入口进入，这样他们就不必坐在候诊室里。
In addition to newborns, immunocompromised and pregnant people are also at higher risk of serious complications from measles. To prevent potential exposures in doctors’ offices, providers started screening patients for measles over the phone when scheduling appointments and in person upon arrival. 除了新生儿，免疫功能低下者和孕妇因麻疹引发严重并发症的风险也更高。为了防止在医生办公室发生潜在的接触，医疗服务提供者开始在预约时通过电话，并在患者到达时进行面对面筛查。
Prisma’s Greenville Memorial Hospital, which tested 400 patients for measles during the outbreak and cared for 13 hospitalized patients, didn’t have enough negative-pressure rooms to handle suspected and confirmed cases, so staff had to retrofit regular rooms. That involved bringing in portable air scrubbers and high-efficiency particulate air filters, and at times moving measles patients to a room that didn’t share a common air-handling unit with rooms where non-measles patients were staying. This required the health network’s engineering department to assess ventilation systems and mea… Prisma旗下的格林维尔纪念医院在疫情期间对400名患者进行了麻疹检测，并护理了13名住院患者。由于没有足够的负压病房来处理疑似和确诊病例，工作人员不得不对普通病房进行改造。这包括引入便携式空气净化器和高效微粒空气过滤器（HEPA），有时还将麻疹患者转移到不与非麻疹患者病房共用空气处理装置的房间。这需要医疗网络的工程部门对通风系统进行评估并……