Weitekamp M R, Schan P, Aber R C
Am J Infect Control. 1985 Oct;13(5):193-8. doi: 10.1016/0196-6553(85)90057-4.
Inadvertent or uncontrolled introduction of varicella-zoster virus into the hospital environment occurs commonly and must be investigated in a systematic and efficient manner to minimize secondary spread to patients (particularly the immunocompromised) or hospital personnel. On the basis of a review of the literature and our practical experience with 11 such exposures to varicella-zoster virus during a 2-year period, we have developed a working algorithm for such investigations. Index cases most often are children, resident physicians, students, young nurses, and ancillary personnel, or adult patients with herpes zoster. A negative or uncertain past history of this infection is an unreliable predictor of susceptibility among the exposed and should be confirmed by serology tests or delayed hypersensitivity skin testing. An incubation-contagion timetable, coupled with a stratification of risk among the exposed, permits a prioritized response in dealing with an introduction of varicella-zoster virus. The preemployment screening of all hospital workers for susceptibility to varicella-zoster virus should be considered as a practical and cost effective policy.
水痘带状疱疹病毒意外或失控地传入医院环境的情况很常见，必须以系统且高效的方式进行调查，以尽量减少其向患者（尤其是免疫功能低下者）或医院工作人员的二次传播。基于对文献的回顾以及我们在两年期间对11起此类水痘带状疱疹病毒暴露事件的实际经验，我们制定了一份针对此类调查的实用算法。索引病例最常见的是儿童、住院医师、学生、年轻护士和辅助人员，或患有带状疱疹的成年患者。这种感染过去病史为阴性或不确定，并不能可靠地预测暴露者的易感性，应通过血清学检测或迟发型超敏皮肤试验加以确认。潜伏期-传染时间表，再加上对暴露者进行风险分层，有助于在应对水痘带状疱疹病毒传入时做出优先反应。应考虑将对所有医院工作人员进行水痘带状疱疹病毒易感性的入职前筛查作为一项切实可行且具有成本效益的政策。
