State hospital nearly
back to normal
after rubella scare

Patients and staff were vaccinated
after a patient was diagnosed
with the disease

By Helen Altonn
Star-Bulletin

The Hawaii State Hospital expects to return to normal operations next Saturday following a German measles (rubella) scare that started last month.

The scare began Feb. 9 when one patient was diagnosed with the disease. Since then, all 650 staff members and the other 159 patients were vaccinated unless they could prove they were immune to rubella, said hospital administrator Barbara Peterson.

Patients also have not been able to leave the hospital grounds, and people have not been allowed to visit without proof of immunity to the contagious viral disease, she said.

Eight patients and employees were suspected of being infected, but some may have been false positives, Peterson said. Only two male patients had symptoms, she added, explaining the others -- mostly employees -- may have developed a response to the vaccine.

Symptoms include upper respiratory tract infection, fever, swollen lymph glands and a rash with small spots.

Rubella can cause congenital malformations if a pregnant woman is exposed to it.

The virus still is present at birth, and a baby can be contagious. Peterson said the hospital has some pregnant employees. "I don't remember the numbers, but all are receiving prenatal care and they're fine," she said.

The Department of Health's epidemiology staff and Dr. Raul Rudoi, pediatrician at Kapiolani Medical Center for Women and Children, assisted the hospital in dealing with the potential outbreak.

"We had rubella experts come in, did in-services and all kinds of education and posted information everywhere," Peterson said. Dr. Paul Effler, chief of the DOH Epidemiology Branch, said blood samples were first sent to a mainland commercial laboratory, then redirected to the Centers for Disease Control and Prevention to confirm the results.

"Some folks develop a rash after they're vaccinated, and you can't tell whether it's an actual rubella case or response to the vaccine," he said. "To err on the side of caution, we consider those cases to be rubella cases unless proven otherwise."

Peterson said some patients' scheduled discharge from the hospital was delayed while testing and vaccinations were completed. "As long as we knew the immune status of the individual we were treating, they were discharged," she said.

Employees believed to be infected remained home until symptoms cleared, she said.