Seng C, Watkins P, Morse D, Barrett S P, Zambon M, Andrews N, Atkins M, Hall S, Lau Y K, Cohen B J
PHLS Communicable Disease Surveillance Centre, London.
Epidemiol Infect. 1994 Oct;113(2):345-53. doi: 10.1017/s0950268800051773.
In November and December 1992, an outbreak of parvovirus B19 infection occurred among patients and staff on an adult mixed surgical ward at a large hospital in London. Three patients and 15 staff members were serologically confirmed as acute cases. The attack rate among susceptible members of staff was 47%. In those infected, arthralgia (80%) and rash (67%) were the most common symptoms. Of six susceptible in-patients on the ward, three became infected. One of the in-patients who had carcinoma of the mouth was viraemic for more than 10 days with marrow suppression resulting in the postponement of chemotherapy until intravenous immunoglobulin was given and he was no longer viraemic. Control measures taken included closure of the ward to new admissions, transfer of only immune staff to the ward, and restriction of the ward nursing staff to working only on that ward. Although no specific exposure was conclusively identified as a risk factor, there was a suggestion of an increased risk of acquiring parvovirus B19 infection among those staff who did not adopt strict hand washing procedures after each physical contact with a patient (RR = 2.33; P = 0.07). Knowledge of parvovirus B19 among interviewed health care workers was poor: only 42% reported knowing about parvovirus B19 and only 38% could name a patient category at risk of a severe outcome following infection. This is the first report of a nosocomial outbreak affecting an adult ward and of possible transmission of parvovirus B19 infection from staff to in-patients. Hospital control of infection teams should include parvovirus B19 in their outbreak containment plans.
1992年11月和12月，伦敦一家大型医院的成人综合外科病房的患者和工作人员中发生了B19细小病毒感染暴发。3名患者和15名工作人员血清学确诊为急性病例。易感工作人员的感染率为47%。感染者中，关节痛（80%）和皮疹（67%）是最常见的症状。病房里6名易感住院患者中有3人被感染。1名口腔癌住院患者病毒血症持续超过10天，伴有骨髓抑制，导致化疗推迟，直到给予静脉注射免疫球蛋白且不再有病毒血症。采取的控制措施包括病房不再接收新入院患者，仅将有免疫力的工作人员调至该病房，以及限制病房护理人员仅在该病房工作。尽管没有明确确定任何特定暴露为危险因素，但有迹象表明，在每次与患者进行身体接触后未采取严格洗手程序的工作人员中，感染B19细小病毒的风险增加（相对危险度=2.33；P=0.07）。接受访谈的医护人员对B19细小病毒的了解较差：只有42%的人报告了解B19细小病毒，只有38%的人能说出感染后有严重后果风险的患者类别。这是关于影响成人病房的医院感染暴发以及B19细小病毒感染可能从工作人员传播给住院患者的首份报告。医院感染控制小组应将B19细小病毒纳入其暴发控制计划。
