Implication of health care personnel in measles transmission

Abstract

Healthcare personnel (HCP) play an important role in transmission of highly contagious diseases such as measles. Current immunization guidelines in Catalonia include Measles-Mumps-Rubella (MMR) immunization for HCP born after 1967 without evidence of immunity. Despite high vaccination coverage (90%) a high burden of measles cases related to outbreaks have occurred. The aim of this study was to assess the implication of HCP in measles transmission related to healthcare setting. A review of surveillance case data from 2001 to 2013 gathered through the Measles Elimination Program in Catalonia was performed. Twenty six outbreaks involving 797 cases were reported, 52 (6.5%) were HCP aged 21–41 years, 72,5% (38) patient were care personnel (doctors and nurses) and 22,5% (14) other health care related personnel. Forty six 87%) were unvaccinated, 4(10%) had only one dose and 2 had two doses of MMR. In community outbreaks 30 clusters with HCP involved were observed, yet none were identified as index cases. Non-vaccinated HCPs against measles were all under 45 years of age. Vaccination is the only reliable protection against nosocomial spread of measles from HCPs. Assessing vaccination status of HCPs and implementing a 2 dose vaccination in those lacking evidence of immunity is needed in order to set to zero the risk of acquiring and spreading measles in healthcare (HC) settings.

Keywords: :

• Measles outbreaks
• Healthcare Personnel
• Immunization
• Nosocomial setting
• Measles elimination

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Corrigendum

Disclosure of Potential Conflicts of Interest

No potential conflicts of interest were disclosed.

Acknowledgements

We thank all reporting physicians and the other members of the Measles Elimination Program Surveillance Network of Catalonia: Alseda M, Alvarez J, Arias C, Artigues A, Balaña PJ, Carmona G, Carol M, Ciruela P, Company M, Follia N, Godoy P, Hernandez S, Izquierdo C, Martinez A, Plasencia E, Recasens A, Rodes A, Rovira A, Ruiz L, Sala MR, Torres J (Public Health Agency of Catalonia), and Caylà J, Manzanares S, Santomà MJ, Clos, R Masdeu E, Simon P, Garcia R, Gorrindo P (Public Health Agency of Barcelona), and Costa J, Isanta R and Mosquera MM (Service of Microbiology, H Clinic of Barcelona).

Financial Disclosure

This work was partially supported by the Agency for the Management of Grants for University Research (AGAUR Grant number 2014 SAGR 1403) and CIBER Epidemiology and Public Health (CIBERESP).