Breakthrough Varicella Infection in a Healthcare Worker Despite Immunity After Varicella Vaccination

1999 ◽  
Vol 20 (8) ◽  
pp. 561-562 ◽  
Author(s):  
Rebecca Wurtz ◽  
Irene J. Check
Keyword(s):  
Healthcare Worker ◽  
Healthcare Workers ◽  
Healthcare Setting ◽  
Varicella Vaccination ◽  
Varicella Infection ◽  
Breakthrough Infection

AbstractAlthough varicella vaccination is recommended for varicella-susceptible healthcare workers (HCWs), breakthrough infection after vaccination is not unusual, especially following household exposures. We report breakthrough varicella in a vaccinated HCW and review the data on breakthrough infection and concerns for the healthcare setting.

Controlling Varicella in the Healthcare Setting: Barriers to Varicella Vaccination Among Healthcare Workers

1999 ◽  
Vol 20 (7) ◽  
pp. 516-518 ◽  
Author(s):  
Mahmooda Qureshi ◽  
Steven M. Gordon ◽  
Belinda Yen-Lieberman ◽  
David G. Litaker
Keyword(s):  
Patient Care ◽  
Varicella Zoster Virus ◽  
Virus Vaccine ◽  
Healthcare Workers ◽  
Healthcare Setting ◽  
Direct Patient Care ◽  
Varicella Vaccination ◽  
Varicella Zoster ◽  
Varicella Zoster Virus Vaccine

AbstractWe surveyed healthcare workers to determine factors that may influence acceptance of varicella-zoster virus vaccine. Of 2,801 workers tested, 90 were susceptible to varicella; of workers offered vaccination, 68% accepted. Workers providing direct patient care were 3.7-fold more likely than other workers to accept VZV vaccination (P=.04).

scholarly journals SARS-Coronavirus-2 cases in healthcare workers may not regularly originate from patient care: lessons from a university hospital on the underestimated risk of healthcare worker to healthcare worker transmission

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Sandra Schneider ◽  
Brar Piening ◽  
Pauline Assina Nouri-Pasovsky ◽  
Anne Caroline Krüger ◽  
Petra Gastmeier ◽  
...  
Keyword(s):  
Healthcare Worker ◽  
Healthcare Workers ◽  
Critical Role ◽  
Healthcare Setting ◽  
University Hospital ◽  
Contact Tracing ◽  
Healthcare Facilities ◽  
University Medicine ◽  
Healthcare Associated ◽  
Epidemiological Link

Abstract Background Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents an unprecedented healthcare challenge. Various SARS-CoV-2 outbreaks in healthcare facilities have been reported. Healthcare workers (HCWs) may play a critical role in the spread of the virus, particularly when asymptomatic. We examined four healthcare-associated outbreaks of SARS-CoV-2 infections that occurred at a university hospital in Berlin, Germany. We aimed to describe and analyze the spread of the virus in order to draw conclusions for effective containment of SARS-CoV-2 in healthcare facilities. Methods Healthcare-associated outbreaks of SARS-CoV-2 infections were defined as two or more laboratory confirmed infections with SARS-CoV-2 where an epidemiological link within the healthcare setting appeared likely. We focused our analysis on one of three sites of the Charité-University Medicine hospital within a 2 month period (March and April 2020). Results We observed four healthcare-associated outbreaks of SARS-CoV-2 infections, with a total of 24 infected persons (23 HCWs and one patient). The outbreaks were detected in the departments of nephrology and dialysis (n = 9), anesthesiology (n = 8), surgical pediatrics (n = 4), and neurology (n = 3). Each outbreak showed multiple unprotected contacts between infected HCWs. A combination of contact tracing, testing, physical distancing and mandatory continuous wearing of face masks by all HCWs was able to contain all four outbreaks. Conclusions HCW to HCW transmission represented the likely source of the four outbreaks. Ensuring proper physical distancing measures and wearing of protective equipment, also when interacting with colleagues, must be a key aspect of fighting COVID-19 in healthcare facilities.

scholarly journals Epidemiological characteristics of breakthrough varicella infection during varicella outbreaks in Shanghai, 2008–2014

2017 ◽  
Vol 145 (10) ◽  
pp. 2129-2136 ◽  
Author(s):  
Y. F. ZHU ◽  
Y. F. LI ◽  
Y. DU ◽  
M. ZENG
Keyword(s):  
Average Duration ◽  
Varicella Vaccine ◽  
Varicella Vaccination ◽  
Infection Rates ◽  
Varicella Infection ◽  
Breakthrough Infection ◽  
The Mean ◽  
Epidemiological Characteristics ◽  
Mean Time ◽  
Index Cases

SUMMARYThe outbreaks of varicella occurring in kindergartens and schools are increasingly notified in Shanghai despite the implementation of one-dose varicella vaccination. We analyzed surveillance data on the notified outbreaks of varicella in Minhang District of Shanghai during 2008–2014. A total of 13 511 varicella cases and 154 outbreaks involving 1558 (11·5%) cases were reported. Annual attack rates of outbreak-associated varicella in outbreak classes were 5·5%–12%. The mean age of the outbreak-associated cases was 8·6 ± 3·1 years. Among 1558 outbreak cases, 660 (42·4%) received one-dose varicella vaccine previously. The proportions of breakthrough varicella infection during outbreaks ranged from 21·5% in 2008 to 86·1% in 2014. Annual breakthrough infection rates in outbreak classes ranged from 5·4% to 7·4%. Breakthrough cases as index cases results in 9·7% of outbreaks, and the average duration of outbreaks was significantly longer in vaccinated cases as index cases than in unvaccinated cases as index cases (11·3 ± 5·8 days vs. 8·6 ± 6·1 days, P < 0·05). The mean time of breakthrough infection since vaccination was 6·2 ± 2·3 years (range 0·6–13·4 years). One-dose varicella vaccination cannot prevent the varicella outbreaks in kindergartens and schools. A second dose of varicella vaccine should be recommended for children.

Barriers to infection prevention and control practice among Amhara region teaching hospitals in Ethiopia: Qualitative study

2019 ◽  
Vol 15 (2) ◽  
Author(s):  
Walelegn Worku Yallew ◽  
Abera Kumie ◽  
Feleke Moges Yehuala
Keyword(s):  
Healthcare Worker ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Teaching Hospitals ◽  
Infection Prevention And Control ◽  
Amhara Region ◽  
Implementation Barriers ◽  
Control Practice ◽  
And Control

Healthcare workers have good perception towards infection prevention, but there has been a poor practice towards it. Therefore, the aim of this study was to explore barriers to practice of infection prevention and control practice in teaching hospitals in Amhara region. A phenomenological approach used to explore the lived experience of healthcare workers and management staffs towards infection prevention practice and control. The data was collected from ten in-depth interviews and 23 focus group discussion participants, by face to face interview using open ended interview performed in safe and quiet places. Data was managed using OpenCode software version 4.03 and contents were analyzed thematically. Totally ten different barriers were identified, such as availability of facilities, shortage of material supply, lack of maintenance of facilities and equipment, high patient flow, experience, emergency situation, healthcare worker behaviour and healthcare worker’s information about infection prevention, low awareness of patients and visitors and overflow of families and visitors to the hospital. For effective infection prevention practice implementation, barriers should be considered via identifying specific organizational, healthcare worker, patients and visitors as targets.

An Inquiry into Unionizing Home Healthcare Workers: Benefits for Workers and Patients

2003 ◽  
Vol 29 (1) ◽  
pp. 117-138
Author(s):  
Kristin Jenkins Gerrick
Keyword(s):  
Health Insurance ◽  
Chest Pain ◽  
Healthcare Worker ◽  
Healthcare Workers ◽  
Constant Stress ◽  
Home Healthcare ◽  
Client Needs

Susan Carter has not been feeling well for days. She would like to see a doctor about her chest pain and wheezing, but Susan knows that missing work will leave her client without a replacement and, worse, she could be fired. Susan is a home healthcare worker in Illinois. Like many of her fellow workers, Susan has no health insurance and cannot afford to risk losing her job by going to see a doctor.Often, Susan feels unable to handle the constant stress of her job. She helps her clients bathe and dress, prepares their meals and assists them with their medications and housekeeping. Susan travels by bus daily to care for two to five clients. She carries a pager day and night in case a client needs help with a plugged catheter or another emergency. Susan often has to work seven days a week, and she steps in to care for patients whose caregivers have left for better-paying jobs.

scholarly journals Evaluating the contributions of strategies to prevent SARS-CoV-2 transmission in the healthcare setting: a modelling study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044644
Author(s):  
Xueting Qiu ◽  
Joel C Miller ◽  
Derek R MacFadden ◽  
William P Hanage
Keyword(s):  
Healthcare Workers ◽  
Healthcare Setting ◽  
Stochastic Simulations ◽  
Limited Resources ◽  
Base Case ◽  
Protective Equipment ◽  
Random Testing ◽  
Weekly Basis ◽  
Force Of Infection ◽  
Effective Use

IntroductionSince its onset, the COVID-19 pandemic has caused significant morbidity and mortality worldwide, with particularly severe outcomes in healthcare institutions and congregate settings. To mitigate spread, healthcare systems have been cohorting patients to limit contacts between uninfected patients and potentially infected patients or healthcare workers (HCWs). A major challenge in managing the pandemic is the presence of currently asymptomatic/presymptomatic individuals capable of transmitting the virus, who could introduce COVID-19 into uninfected cohorts. The optimal combination of personal protective equipment (PPE), testing and other approaches to prevent these events is unclear, especially in light of ongoing limited resources.MethodsUsing stochastic simulations with a susceptible-exposed-infected-recovered dynamic model, we quantified and compared the impacts of PPE use, patient and HCWs surveillance testing and subcohorting strategies.ResultsIn the base case without testing or PPE, the healthcare system was rapidly overwhelmed, and became a net contributor to the force of infection. We found that effective use of PPE by both HCWs and patients could prevent this scenario, while random testing of apparently asymptomatic/presymptomatic individuals on a weekly basis was less effective. We also found that even imperfect use of PPE could provide substantial protection by decreasing the force of infection. Importantly, we found that creating smaller patient/HCW-interaction subcohorts can provide additional resilience to outbreak development with limited resources.ConclusionThese findings reinforce the importance of ensuring adequate PPE supplies even in the absence of testing and provide support for strict subcohorting regimens to reduce outbreak potential in healthcare institutions.

scholarly journals Socioeconomic and Behavioral Correlates of COVID-19 Infections among Hospital Workers in the Greater Jakarta Area, Indonesia: A Cross-Sectional Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5048
Author(s):  
Adrianna Bella ◽  
Mochamad Thoriq Akbar ◽  
Gita Kusnadi ◽  
Olivia Herlinda ◽  
Putri Aprilia Regita ◽  
...  
Keyword(s):  
Healthcare Worker ◽  
Healthcare Workers ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Household Size ◽  
Risk Of Infection ◽  
Sectional Study ◽  
Hospital Workers ◽  
Behavioral Correlates ◽  
Cross Sectional

(1) Background: because of close contacts with COVID-19 patients, hospital workers are among the highest risk groups for infection. This study examined the socioeconomic and behavioral correlates of COVID-19 infection among hospital workers in Indonesia, the country hardest-hit by the disease in the Southeast Asia region. (2) Methods: we conducted a cross-sectional study, which collected data from 1397 hospital staff from eight hospitals in the Greater Jakarta area during April–July 2020. The data was collected using an online self-administered questionnaire and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) tests. We employed descriptive statistics and adjusted and unadjusted logistic regressions to analyze the data of hospital workers as well as the subgroups of healthcare and non-healthcare workers. (3) Results: from a total of 1397 hospital staff in the study, 22 (1.6%) were infected. In terms of correlates, being a healthcare worker (adjusted odds ratio (AOR) = 8.31, 95% CI 1.27–54.54) and having a household size of more than five (AOR = 4.09, 1.02–16.43) were significantly associated with a higher risk of infection. On the other hand, those with middle- and upper-expenditure levels were shown to have a lower risk of infection (AOR = 0.06, 0.01–0.66). Behavioral factors associated with COVID-19 infection among healthcare and non-healthcare workers included knowledge of standard personal protective equipment (PPE) (AOR = 0.08, 0.01–0.54) and application of the six-step handwashing technique (AOR = 0.32, 0.12–0.83). (4) Conclusion: among hospital staff, correlates of COVID-19 infection included being a healthcare worker, household size, expenditure level, knowledge and use of PPE, and application of appropriate hand washing techniques.

scholarly journals Acceptability of and symptom findings from an online symptom check-in tool for COVID-19 outpatient follow-up among a predominantly healthcare worker population

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e050444
Author(s):  
Colm Kerr ◽  
Simon O’ Regan ◽  
Donnacha Creagh ◽  
Gerry Hughes ◽  
Una Geary ◽  
...  
Keyword(s):  
Healthcare Worker ◽  
Healthcare Workers ◽  
Primary Objective ◽  
Text Messages ◽  
Online Tool ◽  
Mild Disease ◽  
Healthcare Experiences ◽  
Inpatient Settings ◽  
Cardinal Symptoms

IntroductionHealth systems worldwide have had to prepare for a surge in volume in both the outpatient and inpatient settings since the emergence of COVID-19. Early international healthcare experiences showed approximately 80% of patients with COVID-19 had mild disease and therfore could be managed as outpatients. However, SARS-CoV-2 can cause a biphasic illness with those affected experiencing a clinical deterioration usually seen after day 4 of illness.ObjectiveWe created an online tool with the primary objective of allowing for virtual disease triage among the increasing number of outpatients diagnosed with COVID-19 at our hospital. Secondary aims included COVID-19 education and the promotion of official COVID-19 information among these outpatients, and analysis of reported symptomatology.MethodsOutpatients with acute COVID-19 disease received text messages from the hospital containing a link to an online symptom check-in tool which they were invited to complete.Results296 unique participants (72%) from 413 contacted by text completed the online check-in tool at least once, generating 831 responses from 1324 texts sent. 83% of text recipients and 91% of unique participants were healthcare workers. 7% of responses to the tool were from participants who admitted to a slight worsening of their symptoms during follow-up. Fatigue was the most commonly reported symptom overall (79%), followed by headache (72%). Fatigue, headache and myalgia were the most frequently reported symptoms in the first 3 days of illness. 8% of responses generated in the first 7 days of illness did not report any of the cardinal symptoms (fever, cough, dyspnoea, taste/smell disturbance) of COVID-19. Participants found the tool to be useful and easy to use, describing it as ‘helpful’ and ‘reassuring’ in a follow-up feedback survey (n=140). 93% said they would use such a tool in the future. 39% reported ongoing fatigue, 16% reported ongoing smell disturbance and 14% reported ongoing dyspnoea after 6 months.ConclusionThe online symptom check-in tool was found to be acceptable to participants and saw high levels of engagement and satisfaction. Symptomatology findings highlight the variety and persistence of symptoms experienced by those with confirmed COVID-19 disease

scholarly journals Examining the cost-effectiveness of personal protective equipment for formal healthcare workers in Kenya during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacob Kazungu ◽  
Kenneth Munge ◽  
Kalin Werner ◽  
Nicholas Risko ◽  
Andres I. Vecino-Ortiz ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Healthcare Worker ◽  
Personal Protective Equipment ◽  
Return On Investment ◽  
Healthcare Workers ◽  
Health Economic Evaluation ◽  
Response Strategy ◽  
Decision Analytic Model ◽  
Protective Equipment

Abstract Background Healthcare workers are at a higher risk of COVID-19 infection during care encounters compared to the general population. Personal Protective Equipment (PPE) have been shown to protect COVID-19 among healthcare workers, however, Kenya has faced PPE shortages that can adequately protect all healthcare workers. We, therefore, examined the health and economic consequences of investing in PPE for healthcare workers in Kenya. Methods We conducted a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. We examined two outcomes: 1) the incremental cost per healthcare worker death averted, and 2) the incremental cost per healthcare worker COVID-19 case averted. We performed a multivariate sensitivity analysis using 10,000 Monte Carlo simulations. Results Kenya would need to invest $3.12 million (95% CI: 2.65–3.59) to adequately protect healthcare workers against COVID-19. This investment would avert 416 (IQR: 330–517) and 30,041 (IQR: 7243 – 102,480) healthcare worker deaths and COVID-19 cases respectively. Additionally, such an investment would result in a healthcare system ROI of $170.64 million (IQR: 138–209) – equivalent to an 11.04 times return. Conclusion Despite other nationwide COVID-19 prevention measures such as social distancing, over 70% of healthcare workers will still be infected if the availability of PPE remains scarce. As part of the COVID-19 response strategy, the government should consider adequate investment in PPE for all healthcare workers in the country as it provides a large return on investment and it is value for money.

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