Changes in measles seroepidemiology of healthcare workers in southern Taiwan

Ho, Tzong Shiann; Wang, S. M.; Wang, L. R.; Liu, C. C.

doi:10.1017/s0950268811000598

Cited by 9 publications

(9 citation statements)

References 28 publications

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“…In Asia and the Western Pacific, studies published between 1994–2012 found 1.7%- 18.9% (median 10.3%) of healthcare personnel had negative measles titers [66–73] with younger age groups at higher risk for being measles seronegative [67, 68, 70–72]. Studies from the Middle East published between 2005–2012 found a median proportion of healthcare personnel who were seronegative of 9.2%, with seronegativity ranging from 1.4% in a study of healthcare staff in Turkey to 46% in medical students in United Arab Emirates [74–82].…”

Section: Resultsmentioning

confidence: 99%

A global perspective of vaccination of healthcare personnel against measles: Systematic review

Fiebelkorn

Seward

Orenstein

2014

Vaccine

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Measles transmission has been well documented in healthcare facilities. Healthcare personnel who are unvaccinated and who lack other evidence of measles immunity put themselves and their patients at risk for measles. We conducted a systematic literature review of measles vaccination policies and their implementation in healthcare personnel, measles seroprevalence among healthcare personnel, measles transmission and disease burden in healthcare settings, and impact/costs incurred by healthcare facilities for healthcare-associated measles transmission. Five database searches yielded 135 relevant articles; 47 additional articles were found through cross-referencing. The risk of acquiring measles is estimated to be 2 to 19 times higher for susceptible healthcare personnel than for the general population. Fifty-three articles published worldwide during 1989–2013 reported measles transmission from patients to healthcare personnel; many of the healthcare personnel were unvaccinated or had unknown vaccination status. Eighteen articles published worldwide during 1982–2013 described examples of transmission from healthcare personnel to patients or to other healthcare personnel. Half of European countries have no measles vaccine policies for healthcare personnel. There is no global policy recommendation for the vaccination of healthcare personnel against measles. Even in countries such as the United States or Finland that have national policies, the recommendations are not uniformly implemented in healthcare facilities. Measles serosusceptibility in healthcare personnel varied widely across studies (median 6.5%, range 0%-46%) but was consistently higher among younger healthcare personnel. Deficiencies in documentation of two doses of measles vaccination or other evidence of immunity among healthcare personnel presents challenges in responding to measles exposures in healthcare settings. Evaluating and containing exposures and outbreaks in healthcare settings can be disruptive and costly. Establishing policies for measles vaccination for healthcare personnel is an important strategy towards achieving measles elimination and should be a high priority for global policy setting groups, governments, and hospitals.

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Section: Resultsmentioning

confidence: 99%

A global perspective of vaccination of healthcare personnel against measles: Systematic review

Fiebelkorn

Seward

Orenstein

2014

Vaccine

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“…Before hospitalization of all children younger than 12 months in the hospital setting of high risk for complications of measles, vaccination of unvaccinated mothers or those without the proof of measles IgG seropositivity was recommended also. Furthermore, vaccination with one dose of MMR vaccine was required for all unvaccinated or partly vaccinated medical students involved in hospital practice [50].…”

Section: Discussionmentioning

confidence: 99%

Sero-epidemiological study in prediction of the risk groups for measles outbreaks in Vojvodina, Serbia

et al. 2019

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Background Age-stratified serologic surveys provide insight into the gaps of measles-specific immunity as well as estimates of the age-specific seroprevalence. The aim of this study was to describe the measles sero-epidemiology in Vojvodina before the occurrence of outbreak in 2017/18 and to discuss preventive measures for potential future epidemics. Methods A seroprevalence study was conducted from April 2015 to June 2017 on serum bank of 3199 residual samples. Study was performed prior to the last measles outbreak in Vojvodina that occurred between 12th November 2017 and 30th June 2018. Measles-specific IgG antibodies were determined using an indirect chemiluminescent immunoassay (CLIA). Results Median age of enrolled participants was 20 years (IQR 11–37). Overall, 86.9% serum samples were seropositive. The highest proportion of measles seronegativity was observed in children aged 12–23 months of age and in adults aged 20–39 years (56.1% and 18.5%, respectively). Prevalence of measles seronegativity above WHO target levels susceptibility was observed in the following age groups: 2, 7, 13, 15, and among all adults aged between 20 and 49 years. Out of total measles outbreak cases (177), there were 91 (51.4%) participants aged 20–39 years. A significant positive correlation was observed between measles seronegativity and the number of reported measles cases aged ≥ 12 months (r = 0.4675, p = 0.0213). Conclusions In order to prevent new outbreaks and achieve the elimination of measles in Vojvodina, the vaccination coverage of both measles-mumps-rubella (MMR1 and MMR2) vaccines needs to be improved and sustained. Educational campaigns for the improvement of acceptance and timely vaccination with vaccine against measles among doctors and the general population are crucial. Our results indicate possible gap in measles protection in adults born during implementation of one dose of measles vaccine and prioritize supplementary immunization activities targeting adults in Vojvodina, Serbia.

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“…Measles antibody positivity was 74.7% in Taiwan [21], 80% in Japan [25] and 85.8% at baseline in this study. In a study conducted between 2004 and 2009 on health care workers at a hospital in southern Taiwan, Ho et al found that measles antibody positivity was 78.1% for the age group 20–29 years [26]. However, measles seropositivity for the age group 20–29 years in first-line medical personnel in our hospital in 2018 was even lower than reported by Ho et al…”

Section: Discussionmentioning

confidence: 63%

Observational study of a new strategy and management policy for measles prevention in medical personnel in a hospital setting

Liu

Luor

2019

BMC Infect Dis

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Background At the end of March 2018, a clustered outbreak of measles associated with health care workers occurred in northern Taiwan. Prior to this study, the policy for measles vaccination for physicians and nurses in MacKay Memorial Hospital, Taiwan was encouragement of vaccination in medical personnel working in the emergency room or other high risk divisions without prior testing for measles antibody, and vaccination coverage was only 85.3%. It was important to urgently formulate a new strategy to achieve zero tolerance for intra-hospital transmission and epidemic prevention. This study aimed to explore the effectiveness of a new strategy for the prevention of an outbreak of measles. Methods This study was conducted from April 23, 2018 to May 22, 2018 in the MacKay Memorial Hospital, a medical center and tertiary teaching hospital with 2200 beds in northern Taiwan. First-line medical personnel in the hospital underwent a free screening for measles antibody as a new strategy for measles outbreak prevention. Susceptible medical personnel were advised to receive measles vaccination. Results A total of 719 first-line medical personnel were enrolled for the general survey. Measles seropositivity was 76.1% (287/377) in the generation born after 1978 (vaccinated), and 96.5% (330/342) in the generation born before 1978 ( p < 0.001), while the overall seropositivity was 85.8% (617/719). Vaccination coverage of susceptible personnel under the new strategy reached 86.3% in the first month (88/102) following the survey. At the end of the first month after implementation of the new strategy, 98.1% of the medical personnel were seropositive or revaccinated, and reached 99.4% at the end of the second month. Conclusions In this study, rapid, free antibody screening during a measles outbreak and subsequent vaccination of those susceptible resulted in most of the first-line medical personnel being seropositive or revaccinated. The new strategy was effective, time saving, used little manpower, and of low cost. Screening for measles antibody free of charge followed by vaccination of seronegative medical personnel can be regarded as an effective health management strategy to reduce and prevent the spread of measles infection.

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Changes in measles seroepidemiology of healthcare workers in southern Taiwan

Cited by 9 publications

References 28 publications

A global perspective of vaccination of healthcare personnel against measles: Systematic review

A global perspective of vaccination of healthcare personnel against measles: Systematic review

Sero-epidemiological study in prediction of the risk groups for measles outbreaks in Vojvodina, Serbia

Observational study of a new strategy and management policy for measles prevention in medical personnel in a hospital setting

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