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Varicella in hospital personnel: a challenge for the infection control practitioner
D Haiduven-Griffiths1, H Fecko
1Infectious Diseases Section (III), Miami Veterans Administration Medical Center, FL.
Abstract:
Five unrelated cases of chickenpox (varicella) occurred in a 1-month period involving one physician, two house staff members, one medical student, and a nursing assistant at a large Veterans Administration medical center. This required immediate identification of susceptible employees and patients to prevent transmission to other personnel and patients. Negative history is not a reliable predictor of susceptibility. Of the fifty contacts reporting negative histories, only five persons (10%) were actually negative by antibody testing. No secondary cases of varicella occurred. These incidents suggested that more rapid prescreening of key hospital personnel with negative histories who have direct patient contact might be helpful in identifying susceptible employees in the future.
Insights
Chickenpox (varicella) outbreaks in hospitals highlight the need for rapid employee screening. Antibody testing is crucial, as a negative history does not reliably predict varicella immunity in healthcare workers.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Occupational Health
Background:
- Healthcare settings are vulnerable to infectious disease transmission.
- Chickenpox (varicella) outbreaks pose risks to patients and staff.
- Previous varicella infection history is an unreliable indicator of immunity.
Purpose of the Study:
- To report on a cluster of varicella cases among hospital staff.
- To assess the reliability of negative varicella history in predicting susceptibility.
- To recommend improved screening protocols for healthcare personnel.
Main Methods:
- Retrospective review of five varicella cases in hospital personnel over one month.
- Contact tracing and antibody testing for susceptibility assessment.
- Evaluation of negative varicella history against serological results.
Main Results:
- Five healthcare workers (physician, house staff, student, nursing assistant) contracted varicella.
- Of 50 contacts with negative varicella history, only 10% were truly susceptible via antibody testing.
- No secondary varicella cases were reported among contacts.
Conclusions:
- A negative varicella history is a poor predictor of immunity in healthcare workers.
- Rapid antibody prescreening of potentially exposed staff is recommended.
- Effective infection control measures prevented further transmission in this cluster.