An innovative multistep outbreak response strategy during a 2025 measles outbreak in the Netherlands

@article{jong2026innovative,
  title = {{An innovative multistep outbreak response strategy during a 2025 measles outbreak in the Netherlands}},
  author = {I De Jong and H Van Brug and E Vanhulle and S Bogers and A Kuiperbak and W Soochit and A Tjon-A-Tsien and J Velzing and K Von Eije and G Sips},
  journal = {The European Journal of Public Health},
  year = {2026},
  month = oct,
  doi = {10.1093/eurpub/ckag169.974},
  url = {https://doi.org/10.1093/eurpub/ckag169.974},
  note = {CC BY-NC 4.0},
}

TY  - JOUR
TI  - An innovative multistep outbreak response strategy during a 2025 measles outbreak in the Netherlands
AU  - I De Jong
AU  - H Van Brug
AU  - E Vanhulle
AU  - S Bogers
AU  - A Kuiperbak
AU  - W Soochit
AU  - A Tjon-A-Tsien
AU  - J Velzing
AU  - K Von Eije
AU  - G Sips
PY  - 2026
DA  - 2026/10/01
JO  - The European Journal of Public Health
DO  - 10.1093/eurpub/ckag169.974
UR  - https://doi.org/10.1093/eurpub/ckag169.974
AB  - Issue: Outbreaks of highly contagious diseases pose public health challenges, including high diagnostic demand, strain on healthcare services, intensive contact tracing, and transmission risks in clinical settings. In 2025 a measles outbreak occurred in Rotterdam-Rijnmond (the Netherlands). We piloted an innovative multistep outbreak response strategy.  Description of the problem: To reduce regional healthcare burden and improve operational efficiency, three approaches were implemented during the outbreak. First, a team of trained medical students conducted home-based sampling of suspected cases. Second, in addition to PCR, measles antibody testing was performed on minimally invasive saliva samples from home-sampled individuals. Third, one-way bulk SMS-alerts were used to inform contacts exposed in healthcare settings.  Results: These approaches were integrated into existing workflows. Among 124 individuals with laboratory test results, 19 were home-sampled by the student team. Median time from exanthem onset to result was 3 days (IQR: 2-3.5) for home-based sampling (n = 19), compared to 5 days (IQR: 2-7) for standard testing routes (n = 105). Saliva sampling was perceived as convenient, especially for children, and logistically feasible. Bulk SMS-alerts enabled rapid outreach to large groups and reduced workload compared to phone call-based tracing.  Lessons: This multistep strategy offered practical tools to strengthen outbreak response and reduce workload, particularly in high-demand settings. Professional home-based sampling, including salivary antibody testing, enabled rapid and minimally invasive testing, especially relevant in outbreaks involving children. It may provide quicker disease verification and additional opportunities for timely post-exposure prophylaxis. Bulk SMS-alerts facilitated rapid outreach to exposed contacts. The strategy was implemented through close collaboration between public health and clinical partners, contributing to regional preparedness.  Key messages: • Professional home-based sampling by trained medical students can allow for quick disease verification and additional opportunities for timely post-exposure prophylaxis.  • Bulk SMS-alerts enable rapid and timely outreach to large groups of exposed contacts, while reducing strain on the public health workforce.
SN  - 1101-1262
SN  - 1464-360X
ER  -