Kanamori Hajime, Tokuda Koichi, Ikeda Shinobu, Endo Shiro, Ishizawa Chiyuki, Hirai Yukari, Takahashi Masami, Aoyagi Tetsuji, Hatta Masumitsu, Gu Yoshiaki, Yano Hisakazu, Weber David J, Kaku Mitsuo
Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine.
Tohoku J Exp Med. 2014 Oct;234(2):111-6. doi: 10.1620/tjem.234.111.
Susceptible healthcare personnel (HCP) are at high risk for acquiring and transmitting measles, mumps, rubella, and varicella (MMRV). Presumptive evidence of immunity to MMRV is recommended for HCP. The aim of this investigation was to examine the seroprevalence of MMRV in Japanese HCP and the association with history or vaccination in terms of occupational safety. To improve infection control at our hospital, we also assessed their immune status by implementing prevaccination antibody screening and an immunization program with postvaccination serological testing. We implemented seroprevalence surveys on MMRV antibodies among 243 newly and 2,664 previously hired HCP in a Japanese tertiary care hospital. Self-administered questionnaires about history of MMRV and vaccination with or without written documentation were completed for newly hired HCP. Prevaccination and postvaccination serological tests were performed using virus-specific IgG enzyme-linked immunosorbent assays. Indeed, only a few HCP accurately remembered or had written records of their disease or vaccination history. After our immunization program was implemented, the seropositivity rate reached levels as high as ~98% for measles, rubella, and varicella, and increased to ~80% for mumps. Our program was cost-effective, and no severe adverse reactions were reported. The prevaccination antibody screening for HCP would be helpful, given the lack of written vaccination records or documented disease history, and is also useful for the prevention of adverse reactions associated with unnecessary vaccination. It is important for infection control practitioners to comprehend the immune status of HCP against MMRV, and then provide an appropriate immunization program for susceptible HCP.
易感染的医护人员(HCP)感染和传播麻疹、腮腺炎、风疹和水痘(MMRV)的风险很高。建议对医护人员进行MMRV免疫的推定证据检查。本调查的目的是检查日本医护人员中MMRV的血清流行率以及与职业安全方面的病史或疫苗接种的关联。为了改善我院的感染控制,我们还通过实施接种前抗体筛查和接种后血清学检测的免疫计划来评估他们的免疫状态。我们对一家日本三级护理医院的243名新入职和2664名先前雇佣的医护人员进行了MMRV抗体血清流行率调查。新入职的医护人员完成了关于MMRV病史和有无书面记录的疫苗接种的自我管理问卷。使用病毒特异性IgG酶联免疫吸附试验进行接种前和接种后血清学检测。事实上,只有少数医护人员准确记得或有其疾病或疫苗接种史的书面记录。在我们实施免疫计划后,麻疹、风疹和水痘的血清阳性率高达约98%,腮腺炎的血清阳性率提高到约80%。我们的计划具有成本效益,且未报告严重不良反应。鉴于缺乏书面疫苗接种记录或记录在案的疾病史,对医护人员进行接种前抗体筛查会有所帮助,并且对于预防与不必要接种相关的不良反应也很有用。感染控制从业者了解医护人员对MMRV的免疫状态,然后为易感医护人员提供适当的免疫计划非常重要。