Measles among Healthcare Workers in a Teaching Hospital in Central Italy

Abstract

Four cases of measles infection in HCWs were identified; of the 72 HCWs tested for measles immunity, 50 reported a past history of measles, while 22 underwent serological screening, which showed that all were IgG positive except for one case, which was excluded from duty as recommended. Strict adherence to use of alcohol-based hand rub and rapid implementation of appropriate isolation precautions are essential but insufficient to prevent measles outbreaks in hospital settings. Vaccination is the only reliable protection against nosocomial spread of measles. Therefore, assessing the immunization status of HCW and implementing vaccination strategies are needed in order to virtually set to zero the risk of acquiring and spreading measles in healthcare settings.

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

“…Studies from most regions of the world have described proportions of healthcare personnel without measles IgG antibodies ranging from 0–46% (median 6.5%) [17, 18, 22, 47–98] (Table 1). The proportion of healthcare personnel without measles IgG antibodies was lowest in Africa (median 1.8%, interquartile range 0.9%– 2.6%) and highest in Asia and the Western Pacific (median 10.3%, interquartile range 7.2%- 12.2%) and the Middle East (median 9.2%, interquartile range 4.6%- 13.4%).…”

“…Studies from Europe on measles seroprevalence of healthcare personnel published between 1994 and 2013 reported that a median of 6.0% (interquartile range 3.3%-14%) of healthcare personnel were seronegative to measles, including those who thought they had a history of measles disease and/or history of measles vaccination [22, 48–65]. These articles also found differences in seroprevalence based on age, with older personnel less likely to be seronegative [49, 51–55].…”

“…Deaths from measles acquired in hospital settings highlight that patients exposed to measles in hospitals may be at increased risk for severe outcomes from measles due to age, underlying medical conditions and/or medications that result in an immunocompromised state [99]. Transmission of measles in hospitals and emergency rooms was described during the 1989–1991 U.S. measles resurgence [100] and these settings continue to be documented as sites of measles transmission in recent years in countries around the world [18, 22–24]. In rural communities in developing countries, nosocomial transmission is less well documented as a problem possibly because access to health facilities or their use by community members for diseases such as measles is more limited [21].…”

“…Healthcare personnel, including students in healthcare fields who have clinical rotations and volunteers in medical facilities, should be protected against measles either through vaccination or other acceptable evidence of measles immunity [20, 21]. However, measles outbreaks occurring over the last decade have continued to document the problem of healthcare personnel acquiring and transmitting measles, suggesting deficiencies in establishing or implementing measles vaccine policies for this occupational group [18, 22–24]. …”

Occupational Health and Safety of Healthcare Personnel

“…), psychological (stress etc.) deformation (Bi et al, 2008;Saha et al,2005;Clarke et al, 2002;Sun et al, 2012;Barbadoro et al, 2012;Uchiyama et al, 2013;Wang et al, 2014;Errico et al, 2013;Kişioğlu et al, 2002;Sveinsdóttir, Biering & Ramel, 2006) and they catch contagious diseases such as AIDS, hepatitis; skin diseases such as dermatitis; vascular diseases such as varicosis; and occupational diseases such as cancer due to the fact that their occupational environment safety is not ensured (Berton & Novi, 2012;Horsman & Sheeran, 1995;Bell, 1997).…”