Wright L J, Carlquist J F
Department of Medicine, University of Utah College of Medicine, Salt Lake City.
Infect Control Hosp Epidemiol. 1994 Jan;15(1):8-11. doi: 10.1086/646810.
To assess the potential for nosocomial measles transmission by measuring seropositivity among healthcare workers in Utah.
Blood specimens were collected for measurement of measles IgG antibody by enzyme immunoassay (EIA). Individuals with undetectable or equivocal antibody levels were considered at risk for infection. Employees were grouped according to the decade of their birth, and analyses of serological findings were done by the Mantel-Haenszel chi-square test for trend.
The study was performed in a healthcare organization comprised of six urban and 10 rural hospitals.
Employees (n = 5825) were tested regardless of age, history of disease, or immunization.
There were 599 employees (10.3%) who were nonimmune. A trend showing age-related differences in immunity was not noted among employees born prior to 1957 (4.7% nonimmune). However, for employees born after that time, there was a significant age-associated increase in the percentage of susceptible individuals (P = 0.00001). The rate of susceptibility was 8.1% for individuals born between 1957 and 1959, 16.3% for individuals born during the 1960s, and 33.7% for those born in the 1970s.
We concluded that employees born after 1960 represent a material risk for transmission of measles in the hospital setting. Despite the low percentage of susceptibility among those born before 1957, the 144 susceptible individuals in this group also are at risk for measles transmission. Thus, during periods of increased measles prevalence, we would recommend screening all healthcare workers regardless of age and vaccinating those who are susceptible.
通过检测犹他州医护人员的血清阳性率,评估医院内麻疹传播的可能性。
采集血液标本,采用酶免疫分析法(EIA)检测麻疹IgG抗体。抗体水平检测不到或结果不明确的个体被视为有感染风险。员工按出生年代分组,血清学结果分析采用Mantel-Haenszel卡方趋势检验。
该研究在一个由6家城市医院和10家农村医院组成的医疗保健机构中进行。
对5825名员工进行了检测,无论其年龄、疾病史或免疫接种情况如何。
有599名员工(10.3%)无免疫力。1957年以前出生的员工中未发现与年龄相关的免疫差异趋势(4.7%无免疫力)。然而,对于1957年以后出生的员工,易感个体的百分比随年龄显著增加(P = 0.00001)。1957年至1959年出生的个体易感性率为8.1%,20世纪60年代出生的个体为16.3%,70年代出生的个体为33.7%。
我们得出结论,1960年以后出生的员工在医院环境中存在麻疹传播的重大风险。尽管1957年以前出生的人易感性比例较低,但该组中的144名易感个体也有麻疹传播的风险。因此,在麻疹流行率上升期间,我们建议对所有医护人员进行筛查,无论其年龄大小,并对易感者进行疫苗接种。