Torner Núria, Solano Ruben, Rius Cristina, Domínguez Angela, Surveillance Network Of Catalonia Spain The Measles Elimination Program
a Public Health Agency of Catalonia; Department of Health of the Generalitat of Catalonia;
Hum Vaccin Immunother. 2015;11(1):288-92. doi: 10.4161/hv.36166. Epub 2014 Nov 1.
Healthcare personnel (HCP) play an important role in transmission of highly contagious diseases such as measles. Current immunization guidelines in Catalonia include Measles-Mumps-Rubella (MMR) immunization for HCP born after 1967 without evidence of immunity. Despite high vaccination coverage (90%) a high burden of measles cases related to outbreaks have occurred. The aim of this study was to assess the implication of HCP in measles transmission related to healthcare setting. A review of surveillance case data from 2001 to 2013 gathered through the Measles Elimination Program in Catalonia was performed. Twenty six outbreaks involving 797 cases were reported, 52 (6.5%) were HCP aged 21-41 years, 72,5% (38) patient were care personnel (doctors and nurses) and 22,5% (14) other health care related personnel. Forty six 87%) were unvaccinated, 4(10%) had only one dose and 2 had two doses of MMR. In community outbreaks 30 clusters with HCP involved were observed, yet none were identified as index cases. Non-vaccinated HCPs against measles were all under 45 years of age. Vaccination is the only reliable protection against nosocomial spread of measles from HCPs. Assessing vaccination status of HCPs and implementing a 2 dose vaccination in those lacking evidence of immunity is needed in order to set to zero the risk of acquiring and spreading measles in healthcare (HC) settings.
医护人员在麻疹等高度传染性疾病的传播中起着重要作用。加泰罗尼亚目前的免疫指南包括对1967年以后出生且无免疫证据的医护人员进行麻疹-腮腺炎-风疹（MMR）免疫接种。尽管疫苗接种覆盖率很高（90%），但仍发生了与疫情相关的大量麻疹病例。本研究的目的是评估医护人员在与医疗机构相关的麻疹传播中的影响。对2001年至2013年通过加泰罗尼亚麻疹消除计划收集的监测病例数据进行了回顾。报告了26起疫情，涉及797例病例，其中52例（6.5%）是21至41岁的医护人员，72.5%（38例）患者是护理人员（医生和护士），22.5%（14例）是其他医护相关人员。46例（87%）未接种疫苗，4例（10%）仅接种了一剂MMR，2例接种了两剂MMR。在社区疫情中，观察到30个涉及医护人员的聚集性病例，但没有一个被确定为指示病例。未接种麻疹疫苗的医护人员均在45岁以下。接种疫苗是预防医护人员在医院传播麻疹的唯一可靠保护措施。为了将医疗机构中感染和传播麻疹的风险降至零，需要评估医护人员的疫苗接种状况，并对那些缺乏免疫证据的人员实施两剂疫苗接种。
