BackgroundNursing students can be exposed to patients with hepatitis A virus (HAV) and can represent a vehicle of transmission both for health personnel, patients and relatives.ObjectivesThe aim of this study was to assess the risk of HAV infection in nursing students during their internship.Patients and MethodsA seroprevalence survey on HAV infection was performed on nursing students at the Cagliari university-hospital, together with the assessment of the compliance to preventive measures to decrease the risk of infection during their internship. Blood specimens were obtained from 253 students. All serum samples were tested for anti-HAV antibodies (IgG) by the enzyme-linked immunosorbent assay (ELISA). Compliance to preventive measures was recorded by trained personnel.ResultsOverall HAV seropositivity in nursing students (mean age 24, range 17 - 45 years) was 3%. Compliance to preventive measures was not uniform (6% - 76%) and extremely low in some specific measures targeted to decrease the oral-fecal transmission.ConclusionsThe high proportion of susceptible nursing students can contribute to an increase in the risk of nosocomial transmission, especially when specific preventive measures are not completely applied. Nursing education packages, before starting medical internship, should be implemented in order to increase their compliance to preventive measures, especially in wards at higher risk. Vaccination should be considered in wards at higher risk.

IntroductionHepatitis B (HBV) represents a main occupational infectious disease. Nursing students (NSs) are a risk group for acquiring HBV occupational infection after accidental contact with blood or body fluids contaminated with the virus. During their everyday clinical learning, they are exposed to needle stick injuries and sharp injuries (NSSIs) probably due to limited experience in handling needles.ObjectivesWe assessed the risk of HBV infection and NSSIs rate among italian NSs.MethodsWe evaluated the seroprevalence of HBV markers in a sample of 247 NSs. We analysed the rate of NSSIs in a sample of 640 third-year students.ResultsThe 54% of students were anti-HBs positive, 42% were negative, and 4% had a borderline value (10–11 Ul/ml). One student was serologically HBsAg negative and was positive for anti-HBc (IgG). All participants were negative for HBsAG and Anti HCV. Regarding injuries, 43/640 (7%) occurred among NSs. Among these, 37/43 (86.1%) were caused by NSSIs. The most part of NSSIs occurred in wards of Internal Medicine. NSSIs occurred more frequently during the drawing of patients’ venous blood (24%) and the most commonly injured body area was the first finger (38%).DiscussionResults from NSSIs, as well as those from non-responders, showed that the incidence of injuries among NSs without immunisation is rare. Nevertheless, in case of injury, the risk to contract HBV can be high. This suggests the importance of serological screening and vaccination against HBV. Furthermore, making NSs clinical learning more effective and safe by improving information, education and training are crucial to better manage the HBV infection risk during their internship. The study was conducted with the support of the Italian Ministry of Health, CCM Program 2013.

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