Prevaccination Antibody Screening and Immunization Program for Healthcare Personnel against Measles, Mumps, Rubella, and Varicella in a Japanese Tertiary Care Hospital
Prevaccination Antibody Screening and Immunization Program for Healthcare Personnel against Measles, Mumps, Rubella, and Varicella in a Japanese Tertiary Care Hospital
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DOI：
10.1620/tjem.234.111
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发表时间：
2014-10-01
影响因子：
2.2
通讯作者：
Kaku, Mitsuo
中科院分区：
文献类型：
--
作者：
Kanamori, Hajime;Tokuda, Koichi;Kaku, Mitsuo
易感卫生保健人员（HCP）感染和传播麻疹、腮腺炎、风疹和水痘（MMRV）的风险很高。建议对HCP有对MMRV免疫的推定证据。本调查的目的是检查日本HCP患者中MMRV的血清患病率以及与职业安全接种史或疫苗接种的关系。为了改善医院的感染控制，我们还通过实施疫苗接种前抗体筛查和免疫接种后血清学检测来评估他们的免疫状况。我们对日本一家三级保健医院243名新入职的HCP和2664名以前入职的HCP进行了MMRV抗体的血清流行率调查。新聘用的HCP完成了关于MMRV史和有或没有书面文件的疫苗接种的自我管理问卷。采用病毒特异性IgG酶联免疫吸附法进行疫苗接种前和疫苗接种后血清学检测。事实上，只有少数HCP准确地记住或有他们的疾病或疫苗接种史的书面记录。在我们的免疫规划实施后，麻疹、风疹和水痘的血清阳性率达到了接近98%的水平，而腮腺炎的血清阳性率则增加到接近80%。我们的方案是经济有效的，没有严重的不良反应报告。鉴于缺乏书面疫苗接种记录或病史记录，HCP疫苗接种前抗体筛查将有所帮助，并且对于预防与不必要的疫苗接种相关的不良反应也很有用。了解HCP对MMRV的免疫状况，为HCP易感人群提供适当的免疫接种方案，对感染控制从业者具有重要意义。
Susceptible healthcare personnel (HCP) are at high risk for acquiring and transmitting measles, mumps, rubella, and varicella (MMRV). Presumptive evidence of immunity to MMRV is recommended for HCP. The aim of this investigation was to examine the seroprevalence of MMRV in Japanese HCP and the association with history or vaccination in terms of occupational safety. To improve infection control at our hospital, we also assessed their immune status by implementing prevaccination antibody screening and an immunization program with postvaccination serological testing. We implemented seroprevalence surveys on MMRV antibodies among 243 newly and 2,664 previously hired HCP in a Japanese tertiary care hospital. Self-administered questionnaires about history of MMRV and vaccination with or without written documentation were completed for newly hired HCP. Prevaccination and postvaccination serological tests were performed using virus-specific IgG enzyme-linked immunosorbent assays. Indeed, only a few HCP accurately remembered or had written records of their disease or vaccination history. After our immunization program was implemented, the seropositivity rate reached levels as high as similar to 98% for measles, rubella, and varicella, and increased to similar to 80% for mumps. Our program was cost-effective, and no severe adverse reactions were reported. The prevaccination antibody screening for HCP would be helpful, given the lack of written vaccination records or documented disease history, and is also useful for the prevention of adverse reactions associated with unnecessary vaccination. It is important for infection control practitioners to comprehend the immune status of HCP against MMRV, and then provide an appropriate immunization program for susceptible HCP.