scholarly journals Varicella Seroprevalence in Healthcare Workers at a Medical Center Following Changes in National and Local Hospital Vaccination Policies

2019 ◽  
Vol 16 (19) ◽  
pp. 3544
Author(s):  
Meng-Ting Tsou ◽  
Hsin-Hui Shao
Keyword(s):  
Healthcare Workers ◽  
Medical Center ◽  
Geometric Mean ◽  
Varicella Vaccine ◽  
Health Check ◽  
Care Hospital ◽  
Hospital Policy ◽  
Effective Prevention ◽  
Varicella Zoster ◽  
Seroprevalence Data

Background: Varicella seroprevalence in healthcare workers at a tertiary care hospital in Taiwan was assessed following the inclusion of varicella zoster vaccination in the national vaccination schedule in 2004 and was made a hospital policy in 2008. Methods: Seroprevalence data were extracted from records of pre-employment health check-ups performed between 2008 and 2018 at a single medical center. Staff with complete medical records and anti-varicella zoster virus immunoglobulin G (VZV IgG) titers were included. Sex and age group differences in terms of geometric mean titer (GMT) were compared using analysis of variance and chi-squared tests. The significance of the correlation between age and the anti-VZV IgG titer was tested by linear regression. The odds of significant associations among age, sex, vocation, and the years of national and hospital adoption of vaccination were determined using univariate and multivariate analyses. p < 0.05 was considered statistically significant. Results: Of the 7314 eligible participants, 5625 (76.90%) were women, and the mean patient age was 26.80 ± 8.00 years. The lowest VZV-positivity rates were in 18–20-year-old women (85.16%; GMT, 362.89 mIU/mL) and men (87.59%; GMT, 288.07 mIU/mL). VZV positivity increased with age (p < 0.001). Participants born before 2002 were more likely to be seropositive than those born after 2003 (odds ratio, 2.51 vs. 1.0; p < 0.001). The lowest seropositive rate was found in the nursing staff (88.91%; 95% confidence interval, 87.74%–90.05%). Varicella vaccine boosters have been required at pre-employment health check-ups since 2008 if anti-VZV antibodies were not detectable. A follow-up evaluation found marginal significant differences in the odds ratios of seropositivity after 2007 (p = 0.052), especially in 2008 and 2014 (p < 0.05) after the hospital policy launched. Conclusions: Despite public health efforts, a small number of healthcare workers were inadequately protected, and antibody titers were lower than required to maintain herd immunity. For effective prevention of nosocomial infection, VZV IgG status should be documented for all HCWs, and susceptible HCWs should be vaccinated to avoid outbreaks. Pre-employment screening and vaccination have increased immunity and need to be conducted to ensure protection of vulnerable patients.

Long-Term Protective Immunity of Recipients of the OKA Strain of Live Varicella Vaccine

PEDIATRICS ◽  
1985 ◽  
Vol 75 (4) ◽  
pp. 667-671 ◽  
Author(s):  
Yoshizo Asano ◽  
Takao Nagai ◽  
Takao Miyata ◽  
Takehiko Yazaki ◽  
Shigemitsu Ito ◽  
...  
Keyword(s):  
Varicella Zoster Virus ◽  
Skin Reaction ◽  
Protective Immunity ◽  
Geometric Mean ◽  
Varicella Vaccine ◽  
Geometric Mean Titer ◽  
Positive Skin ◽  
Varicella Zoster ◽  
Mean Diameter

In spite of close contacts with patients who had varicella, 101 of 106 (95%) healthy and sick children (142 of 147 (97%) exposures of these children) who had received the OKA strain of live varicella vaccine 7 to 10 years earlier were protected against the disease completely. Among them, 37 of 38 (97%) vaccine recipients who received immunologic testing had varicella-zoster virus (VZV) antibodies tested by fluorescent antibody to membrane antigen method with a geometric mean titer of 1:9.3, and 37 of the 38 (97%) showed positive skin reaction to varicella-zoster virus antigen with erythema (mean diameter 13.4 mm). These findings were compared with those for 29 children who had contracted typical varicella 7 to 10 years earlier, whose seropositive rate was 100% with a geometric mean titer of 1:10.5, and 97% of whom (28/29) had positive skin reaction with mean diameter of 12.9 mm. These results indicate that the vaccine-induced protective immunity persists for approximately one decade and is almost equal to the long-term immunity following natural infection.

scholarly journals Use of a smartphone app to inform healthcare workers of hospital policy during a pandemic such as COVID-19: A mixed methods observational study

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262105
Author(s):  
R. I. Helou ◽  
C. M. Waltmans–den Breejen ◽  
J. A. Severin ◽  
M. E. J. L. Hulscher ◽  
A. Verbon
Keyword(s):  
User Experience ◽  
User Satisfaction ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Relevant Information ◽  
Smartphone App ◽  
Care Hospital ◽  
Online Questionnaire ◽  
Hospital Policy ◽  
Treatment Protocols

Objective To evaluate the use of a COVID-19 app containing relevant information for healthcare workers (HCWs) in hospitals and to determine user experience. Methods A smartphone app (Firstline) was adapted to exclusively contain local COVID-19 policy documents and treatment protocols. This COVID-19 app was offered to all HCWs of a 900-bed tertiary care hospital. App use was evaluated with user analytics and user experience in an online questionnaire. Results A total number of 1168 HCWs subscribed to the COVID-19 app which was used 3903 times with an average of 1 minute and 20 seconds per session during a three-month period. The number of active users peaked in April 2020 with 1017 users. Users included medical specialists (22.3%), residents (16.5%), nurses (22.2%), management (6.2%) and other (26.5%). Information for HCWs such as when to test for SARS-CoV-2 (1214), latest updates (1181), the COVID-19 telephone list (418) and the SARS-CoV-2 / COVID-19 guideline (280) were the most frequently accessed advice. Seventy-one users with a mean age of 46.1 years from 19 different departments completed the questionnaire. Respondents considered the COVID-19 app clear (54/59; 92%), easy-to-use (46/55; 84%), fast (46/52; 88%), useful (52/56; 93%), and had faith in the information (58/70; 83%). The COVID-19 app was used to quickly look up something (43/68; 63%), when no computer was available (15/68; 22%), look up / dial COVID-related phone numbers (15/68; 22%) or when walking from A to B (11/68; 16%). Few respondents felt app use cost time (5/68; 7%). Conclusions Our COVID-19 app proved to be a relatively simple yet innovative tool that was used by HCWs from all disciplines involved in taking care of COVID-19 patients. The up-to-date app was used for different topics and had high user satisfaction amongst questionnaire respondents. An app with local hospital policy could be an invaluable tool during a pandemic.

Humoral Immunity and Clinical Reinfections Following Varicella Vaccine in Healthy Children

PEDIATRICS ◽  
1989 ◽  
Vol 84 (3) ◽  
pp. 418-421 ◽  
Author(s):  
Candice Johnson ◽  
Leonard P. Rome ◽  
Terry Stancin ◽  
Mary L. Kumar
Keyword(s):  
Repeated Measures ◽  
Fluorescent Antibody ◽  
Geometric Mean ◽  
Varicella Vaccine ◽  
Critical Issue ◽  
Healthy Children ◽  
Varicella Zoster ◽  
Antibody Persistence ◽  
The Difference ◽  
Post Hoc

The duration of immunity following vancella-zoster vaccination in healthy children remains a critical issue. In a 3-year study of 140 OKA/Merck vaccine recipients, duration of immunity was assessed by two measures. The first was persistence of varicellazoster antibody measured by modified fluorescent antibody to membrane antigen test. Thirty-six toddler vaccinees 12 to 24 months of age had sera obtained at 6 weeks, 1 year, and 2 years. Geometric mean titer ± SD at 6 weeks was 57.7 ± 2.9; at 1 year, it was 12.4 ± 3.9; at 2 years, it was 9.9 ± 3.9. Repeated-measures analysis of variance showed a significant overall decrease in antibody titer with time (F = 30.62, P &lt; .001). Post hoc comparisons indicated that the 6-week and 1-year titers were significantly different (P &lt; .001), but the difference between 1 and 2 years was not (P = .138). Clinical reinfections were also examined for 3 years after vaccination. Suspected varicella cases were confirmed by a fourfold or more increase in titer. Of 84 toddlers, 68 were exposed one or more times, and 6 became reinfected. Of 49 siblings, 45 were exposed, and one became reinfected. All 7 children had &lt; 70 vesicles and 6 of 7 were afebrile. No cases of zoster occurred. It is concluded that OKA/Merck varicella-zoster vaccination leads to antibody persistence for 2 years and the few reinfections that do occur are greatly attenuated.

scholarly journals Mitochondrial Haplogroups as a Risk Factor for Herpes Zoster

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Rebecca T. Levinson ◽  
Todd Hulgan ◽  
Spyros A. Kalams ◽  
Joshua P. Fessel ◽  
David C. Samuels
Keyword(s):  
Risk Factor ◽  
Herpes Zoster ◽  
Medical Center ◽  
International Classification Of Diseases ◽  
Varicella Zoster Virus Infection ◽  
Mitochondrial Haplogroups ◽  
Effective Prevention ◽  
Varicella Zoster ◽  
Mitochondrial Haplogroup ◽  
Classification Of Diseases

Abstract Background.  Herpes zoster, or shingles, is a common, painful reactivation of latent varicella zoster virus infection. Understanding host factors that predispose to herpes zoster may permit development of more effective prevention strategies. Our objective was to examine mitochondrial haplogroups as a potential host factor related to herpes zoster incidence. Methods.  Study participants were drawn from BioVU, a deoxyribonucleic acid (DNA) biobank connected to deidentified electronic medical records (EMRs) from Vanderbilt University Medical Center. Our study used 9691 Caucasian individuals with herpes zoster status determined by International Classification of Diseases, Ninth Revision codes 053–053.9. Cases and controls were matched on sex and date of birth within 5 years. Mitochondrial haplogroups were defined from mitochondrial DNA variants genotyped on the Illumina 660W or Illumina Infinium Human-Exome Beadchip. Sex and date of birth were extracted from the EMR. Results.  European mitochondrial haplogroup H had a protective association with herpes zoster status (odds ratio [OR] = .82; 95% confidence interval [CI], .71–.94; P = .005), whereas haplogroup clade IWX was a risk factor for herpes zoster status (OR = 1.38; 95% CI, 1.07–1.77; P = .01). Conclusions.  Mitochondrial haplogroup influences herpes zoster risk. Knowledge of a patient's mitochondrial haplogroup could allow for a precision approach to the management of herpes zoster risk through vaccination strategies and management of other modifiable risk factors.

scholarly journals Seroprevalence of Measles in Healthcare Workers in South Korea

2020 ◽  
Vol 41 (S1) ◽  
pp. s386-s387
Author(s):  
Sun Kyung Kim ◽  
Jiwon Jung ◽  
Sun Hee Kwak ◽  
Min Jee Hong ◽  
Eun Ok Kim ◽  
...  
Keyword(s):  
South Korea ◽  
Birth Cohort ◽  
Healthcare Workers ◽  
Medical Center ◽  
Adult Population ◽  
Care Hospital ◽  
Healthcare Facilities ◽  
Asan Medical ◽  
Measles Vaccination ◽  
Antibody Tests

Background: Measles is a highly contagious disease that is transmissible by airborne particles but is preventable by vaccination. South Korea has maintained a highly immunized adult population; however, small local outbreaks of measles continued to occur, and there have been some reports of pockets of underimmunity among the young adult population. It is important to know the seroepidemiology of healthcare workers (HCWs) for policy-making process, but data on the seroprevalence of measles in HCWs in South Korea are limited. Methods: We investigated the seroprevalence of HCWs at Asan Medical Center, a 2,705-bed tertiary-care hospital in Seoul, South Korea, with 8,329 HCWs. In 2014, after an outbreak of measles occurred in a university in Seoul, Asan Medical Center required measles IgG tests for all HCWs born in and after 1967 for point-prevalence surveillance. In addition, we have routinely performed measles antibody test for new HCWs since 2014. In 2018, antibody tests were administered to HCWs who were born before 1967 or who had taken a leave of absence in 2014. We provided MMR vaccination to all HCWs whose antibody tests yielded negative results. Results: In total, 7,411 HCWs (89%) underwent measles antibody tests from 2014 to 2018. The overall seropositivity was 73% (95% CI, 72%–74%); seroprevalence was 73% in HCWs born in of after 1967, whereas the seroprevalence in HCWs born before 1967 was 98%. The seroprevalence sharply decreased from 85% in the 1986 birth cohort to 42% in the 1995 birth cohort. Conclusions: In conclusion, the proportion of measles-susceptible individuals was substantially high in HCWs, especially in young adults. Because the impact of measles outbreak in healthcare facilities would be critical, a policy regarding routine serologic screening followed by measles vaccination or routine measles vaccination in healthcare facilities should be considered, especially for young Korean HCWs.Funding: NoneDisclosures: None

scholarly journals Long -Term Persistence of Antibodies Against Varicella in Fully Immunized Healthcare Workers: An Italian Retrospective Cohort Study

2021 ◽  
Author(s):  
Francesco Bianchi ◽  
Silvio Tafuri ◽  
Angela Larocca ◽  
Cinzia Germinario ◽  
Pasquale Stefanizzi
Keyword(s):  
Varicella Zoster Virus ◽  
Healthcare Workers ◽  
Varicella Vaccine ◽  
Serious Adverse Events ◽  
Biological Risk ◽  
Varicella Zoster ◽  
Vaccine Booster ◽  
History Of ◽  
Study Population

Abstract Background. Chickenpox is a highly contagious disease caused by the varicella zoster virus (VZV), and in infants, adolescents, adults, pregnant women, and the immunocompromised it can be serious. The best way to prevent chickenpox is immunization with the varicella vaccine. Protective levels of antibodies induced by the varicella vaccine decline over time, but there is currently no formal recommendation for testing anti-varicella zoster virus (VZV) IgG levels in immunized healthcare workers (HCWs). Methods. The aims of this study were to evaluate the seroprevalence of circulating anti-VZV IgG in a sample a sample of students and residents of the medical school of the University of Bari, the long-term immunogenicity of the varicella vaccine, and the effectiveness of a strategy consisting of a third vaccine booster dose. The study population was screened as part of a biological risk assessment conducted between April 2014 and October 2020. A strategy for the management of non-responders was also examined. Results. The 182 students and residents included in the study had a documented history of immunization (two doses of varicella vaccine). The absence of anti-VZV IgG was determined in 34% (62/182; 95%CI=27.2–41.4%), with serosusceptibility more common among males than females (p<0.05). After a third varicella dose, seroconversion was achieved in 100% of this previously seronegative group. No serious adverse events were recorded. Conclusions. One-third of the study population immunized against VZV lacked a protective antibody titer, but a third dose of vaccine restored protection. Since it is highly unlikely that VZV will be eliminated in the immediate future, the loss of immunity in a substantial portion of the population implies a risk of varicella outbreaks in the coming years. Screening for varicella immunity in routine assessments of the biological risk of medical students and HCWs may help to prevent nosocomial VZV infections.

scholarly journals Long -term persistence of antibodies against varicella in fully immunized healthcare workers: an Italian retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Francesco Paolo Bianchi ◽  
Silvio Tafuri ◽  
Angela Maria Vittoria Larocca ◽  
Cinzia Annatea Germinario ◽  
Pasquale Stefanizzi
Keyword(s):  
Varicella Zoster Virus ◽  
Healthcare Workers ◽  
Varicella Vaccine ◽  
Serious Adverse Events ◽  
Biological Risk ◽  
Varicella Zoster ◽  
Vaccine Booster ◽  
History Of ◽  
Study Population

Abstract Background Chickenpox is a highly contagious disease caused by the varicella zoster virus (VZV), and in infants, adolescents, adults, pregnant women, and the immunocompromised it can be serious. The best way to prevent chickenpox is immunization with the varicella vaccine. Protective levels of antibodies induced by the varicella vaccine decline over time, but there is currently no formal recommendation for testing anti-varicella zoster virus (VZV) IgG levels in immunized healthcare workers (HCWs). Methods The aims of this study were to evaluate the seroprevalence of circulating anti-VZV IgG in a sample a sample of students and residents of the medical school of the University of Bari, the long-term immunogenicity of the varicella vaccine, and the effectiveness of a strategy consisting of a third vaccine booster dose. The study population was screened as part of a biological risk assessment conducted between April 2014 and October 2020. A strategy for the management of non-responders was also examined. Results The 182 students and residents included in the study had a documented history of immunization (two doses of varicella vaccine). The absence of anti-VZV IgG was determined in 34% (62/182; 95%CI = 27.2–41.4%), with serosusceptibility more common among males than females (p < 0.05). After a third varicella dose, seroconversion was achieved in 100% of this previously seronegative group. No serious adverse events were recorded. Conclusions One-third of the study population immunized against VZV lacked a protective antibody titer, but a third dose of vaccine restored protection. Since it is highly unlikely that VZV will be eliminated in the immediate future, the loss of immunity in a substantial portion of the population implies a risk of varicella outbreaks in the coming years. Screening for varicella immunity in routine assessments of the biological risk of medical students and HCWs may help to prevent nosocomial VZV infections.

A Cluster of Primary Varicella Cases Among Healthcare Workers With False-Positive Varicella Zoster Virus Titers

2003 ◽  
Vol 24 (3) ◽  
pp. 202-206 ◽  
Author(s):  
Amy Behrman ◽  
D. Scott Schmid ◽  
Anne Crivaro ◽  
Barbara Watson
Keyword(s):  
Varicella Zoster Virus ◽  
False Positive ◽  
Healthcare Workers ◽  
Screening Program ◽  
Varicella Vaccine ◽  
Varicella Zoster ◽  
Control And Prevention ◽  
Serologic Screening ◽  
Positive Results

AbstractBackground:Five cases of primary varicella zoster virus (VZV) were diagnosed among hospital healthcare workers (HCWs). All had complied with a pre-employment VZV screening program and had been considered immune.Objectives:To summarize the investigation of VZV among un-immunized HCWs and to provide recommendations for avoiding false-positive serologic tests.Design:Risk of transmission of VZV to susceptible HCWs is minimized through serologic screening. Varicella vaccine is recommended for susceptible HCWs. A commercially available latex bead agglutination assay (LA) is widely used because it is rapid and easy to perform. LA was compared with the whole-cell varicella ELISA standardized in the Centers for Disease Control and Prevention (CDC) National Herpes Laboratory.Setting/Population:Large inner-city, tertiarycare hospital with a diverse employee population.Results:In a year, 5 HCWs presented with laboratory-confirmed primary varicella infection. Four had VZV exposures 2 weeks prior to presentation. All had documented positive VZV titers by LA performed at hire. None were offered VZV vaccination. The original LAs were judged false-positives.Intervention/Follow-Up Investigation:Fifty-three consecutive VZV LA samples from the hospital laboratory were retested at the CDC. Forty-four samples concurred. Of the remaining 9, 4 were positive by hospital LA but negative by CDC IgG ELISA. Four were equivocal by hospital LA but negative by CDC IgG ELISA and LA. One was positive by hospital LA but negative by LA and equivocal by ELISA at the CDC.Conclusion:LA may be prone to false-positive results and inappropriate for screening hospital HCWs.

Effect of the Introduction of an Engineered Sharps Injury Prevention Device on the Percutaneous Injury Rate in Healthcare Workers

2007 ◽  
Vol 28 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Madelyn Azar-Cavanagh ◽  
Pam Burdt ◽  
Judith Green-McKenzie
Keyword(s):  
Injury Prevention ◽  
Healthcare Workers ◽  
Medical Center ◽  
Injury Rate ◽  
Needlestick Injury ◽  
Hospital Policy ◽  
Bloodborne Pathogens ◽  
Safety Features ◽  
Sharps Injury ◽  
Hospital Wards

Objective.To evaluate the effect of introducing an engineered device for preventing injuries from sharp instruments (engineered sharps injury prevention device [ESIPD]) on the percutaneous injury rate in healthcare workers (HCWs).Methods.We undertook a controlled, interventional, before-after study during a period of 3 years (from January 1998 through December 2000) at a major medical center. The study population was HCWs with potential exposure to bloodborne pathogens. HCWs who sustain a needlestick injury are required by hospital policy to report the exposure. A confidential log of these injuries is maintained that includes information on the date and time of the incident, the type and brand of sharp device involved, and whether an ESIPD was used.Intervention.Introduction of an intravenous (IV) catheter stylet with a safety-engineered feature (a retractable protection shield), which was placed in clinics and hospital wards in lieu of other IV catheter devices that did not have safety features. No protective devices were present on suture needles during any of the periods. The incidence of percutaneous needlestick injury by IV catheter and suture needles was evaluated for 18 months before and 18 months after the intervention.Results.After the intervention, the incidence of percutaneous injuries resulting from IV catheters decreased significantly (P < .01), whereas the incidence of injuries resulting from suture needle injuries increased significantly (P < .008).Conclusion.ESIPDs lead to a reduction in percutaneous injuries in HCWs, helping to decrease HCWs' risk of exposure to bloodborne pathogens.

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