SECONDARY MEASLES-VACCINE FAILURE IN HEALTH-CARE WORKERS EXPOSED TO INFECTED PATIENTS

被引:34
作者
AMMARI, LK
BELL, LM
HODINKA, RL
机构
[1] UNIV PENN,CHILDRENS HOSP PHILADELPHIA,SCH MED,DEPT PEDIAT,PHILADELPHIA,PA 19104
[2] UNIV PENN,CHILDRENS HOSP PHILADELPHIA,SCH MED,DIV GEN PEDIAT,PHILADELPHIA,PA 19104
[3] UNIV PENN,CHILDRENS HOSP PHILADELPHIA,SCH MED,DEPT PATHOL,PHILADELPHIA,PA 19104
关键词
D O I
10.2307/30147165
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
OBJECTIVE: To describe 4 healthcare workers who developed measles despite pre-existing antimeasles antibody levels. DESIGN: Hospital employees working in patient care areas from July through November 1990 were screened for measles antibody levels using a commercially available enzyme immunoassay (EIA). The clinical course and laboratory evaluation of the 4 healthcare workers who developed measles were reviewed. SETTING: An academic tertiary care children's hospital. PARTICIPANTS: A convenience sample of resident physicians, nurses, ward clerks, Child Life workers, physical and occupational therapists, radiology technicians, and housekeeping staff were screened regardless of age, immunization status, or history of measles infection. RESULTS: Of 1,311 employees working in patient care areas, 900 (68.6%) had sera tested for measles antibody. Fourteen (1.5%) were negative, 338 (37.6%) had low positive antibody levels, 372 (41.3%) were mid-positive, and 171 (19%) were high-positive; 5 (0.6%) showed equivocal results. Four healthcare workers vaccinated in the past developed measles. All had positive pre-illness measles antibody levels and all had a significant rise in measles-specific IgG following infection. Three of the them had received at least 2 live measles vaccinations prior to caring for patients with measles. CONCLUSIONS: These cases raise concerns regarding detection of adequate protective measles immunity. We recommend that all healthcare workers observe respiratory precautions in caring for patients with measles.
引用
收藏
页码:81 / 86
页数:6
相关论文
共 22 条
  • [1] REVACCINATION OF PREVIOUSLY VACCINATED SIBLINGS OF CHILDREN WITH MEASLES DURING AN OUTBREAK
    ADDISS, DG
    BERG, JL
    DAVIS, JP
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1988, 157 (03) : 610 - 611
  • [2] VARICELLA-ZOSTER IMMUNOGLOBULINS DURING VARICELLA, LATENCY, AND ZOSTER
    BRUNELL, PA
    GERSHON, AA
    UDUMAN, SA
    STEINBERG, S
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1975, 132 (01) : 49 - 54
  • [3] MEASLES ANTIBODY - REEVALUATION OF PROTECTIVE TITERS
    CHEN, RT
    MARKOWITZ, LE
    ALBRECHT, P
    STEWART, JA
    MOFENSON, LM
    PREBLUD, SR
    ORENSTEIN, WA
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1990, 162 (05) : 1036 - 1042
  • [4] CLINICAL AND SEROLOGIC STUDY OF 103 CHILDREN WITH MEASLES VACCINE FAILURE
    CHERRY, JD
    FEIGIN, RD
    SHACKELFORD, PG
    HINTHORN, DR
    SCHMIDT, RR
    [J]. JOURNAL OF PEDIATRICS, 1973, 82 (05) : 802 - 808
  • [5] URBAN MEASLES IN VACCINE ERA - CLINICAL, EPIDEMIOLOGIC, AND SEROLOGIC STUDY
    CHERRY, JD
    SHIRLEY, RH
    SHACKELFORD, PG
    LOBES, LA
    LINS, RD
    HINTHORN, DR
    CHOI, SC
    FEIGIN, RD
    [J]. JOURNAL OF PEDIATRICS, 1972, 81 (02) : 217 - +
  • [6] METHODS FOR SCREENING THE NATURALLY ACQUIRED AND VACCINE-INDUCED IMMUNITY TO THE MEASLES-VIRUS
    CHRISTENSON, B
    BOTTIGER, M
    [J]. BIOLOGICALS, 1990, 18 (03) : 207 - 211
  • [7] TRANSMISSION OF MEASLES IN MEDICAL SETTINGS - 1980 THROUGH 1984
    DAVIS, RM
    ORENSTEIN, WA
    FRANK, JA
    SACKS, JJ
    DALES, LG
    PREBLUD, SR
    BART, KJ
    WILLIAMS, NM
    HINMAN, AR
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1986, 255 (10): : 1295 - 1298
  • [8] MILD MEASLES AND SECONDARY VACCINE FAILURE DURING A SUSTAINED OUTBREAK IN A HIGHLY VACCINATED POPULATION
    EDMONSON, MB
    ADDISS, DG
    MCPHERSON, JT
    BERG, JL
    CIRCO, SR
    DAVIS, JP
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1990, 263 (18): : 2467 - 2471
  • [9] MEASLES OUTBREAK IN A FULLY IMMUNIZED SECONDARY-SCHOOL POPULATION
    GUSTAFSON, TL
    LIEVENS, AW
    BRUNELL, PA
    MOELLENBERG, RG
    BUTTERY, CMG
    SEHULSTER, LM
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1987, 316 (13) : 771 - 774
  • [10] HULL HF, 1985, PEDIATRICS, V76, P518