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意大利中部一所教学医院的医护人员中出现麻疹。

Measles among healthcare workers in a teaching hospital in central Italy.

机构信息

Department of Biomedical Science and Public Health, Section of Hygiene, Public Health and Preventive Medicine, Università Politecnica delle Marche, Italy.

出版信息

J Occup Health. 2012;54(4):336-9. doi: 10.1539/joh.12-0016-br. Epub 2012 May 18.

Abstract

OBJECTIVES

The aim of this report is to describe a measles cluster involving health-care workers (HWCs) that occurred in a teaching hospital in central Italy during winter 2011 and the efforts made to promptly identify all the susceptible contacts in order to stop, as soon as possible, transmission of the infection within the hospital.

METHODS

An epidemiological investigation took place. The immunization status of all the exposed individuals was assessed by personal interviews (history of measles or measles vaccine). Serologie screening for personnel not immune to measles was performed.

RESULTS

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.

摘要

目的

本报告旨在描述 2011 年冬季意大利中部一所教学医院发生的一起麻疹疫情,该疫情涉及医务人员(HWCs)。报告描述了为尽快识别所有易感接触者而做出的努力,以便尽快阻止医院内感染的传播。

方法

开展了一项流行病学调查。通过个人访谈(麻疹或麻疹疫苗史)评估所有接触者的免疫状况。对未对麻疹免疫的人员进行血清学筛查。

结果

发现 4 例医务人员麻疹感染病例;对 72 名医务人员进行麻疹免疫检测,50 人报告有麻疹既往史,22 人接受血清学筛查,除 1 人因建议而被排除工作外,其余均为 IgG 阳性。严格遵守使用含酒精的手部消毒剂和快速实施适当的隔离预防措施至关重要,但不足以防止医院环境中的麻疹爆发。接种疫苗是预防医院内麻疹传播的唯一可靠保护措施。因此,需要评估医务人员的免疫状况并实施疫苗接种策略,以便在医疗保健环境中几乎将获得和传播麻疹的风险降至零。

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