Measles susceptibility and immunization: experiences in a forensic psychiatric hospital.

BACKGROUND: In response to a measles outbreak in the community, a measles immunization program was developed at our hospital for forensic psychiatric patients. METHODS: Measles antibody screening of all employees and patients by means of an enzyme-linked immunosorbent assay was followed by vaccination of susceptible persons. RESULTS: Serum samples from 813 employees and 868 patients during a 6-month period were analyzed. The susceptibility rate was 16.15% for employees and 13.60% for patients born in or after 1957. It was 4.67% for employees and 5.40% for patients born before 1957. The overall rate was 7.38% for employees and 8.53% for patients. A rate of 5% is known to be sufficient for transmission in institutions. Vaccine was given to 84.51% of susceptible patients. Vaccine failure occurred in 8.33%. Residual susceptibility rate was 1.84%. CONCLUSIONS: Cost analysis showed that screening of all individuals and immunization of susceptible persons was the most cost-effective method for measles control in our institutional setting.