Hostname: page-component-745bb68f8f-grxwn Total loading time: 0 Render date: 2025-01-14T20:41:41.467Z Has data issue: false hasContentIssue false
  • English
  • Français

Readers:' Forum: Nosocomial Rubella—Consequences of an Outbreak and Efficacy of a Mandatory Immunization Program

Published online by Cambridge University Press:  02 January 2015

Peter N.R. Heseltine ,
Marie Ripper  and
Patricia Wohlford
Peter N.R. Heseltine*
Affiliation:
Departments of Hospital Epidemiology and Medicine, Los Angeles County-, University of Southern California Medical Center, and the University of Southern California School of Medicine, Los Angeles, California
Marie Ripper
Affiliation:
Departments of Hospital Epidemiology and Medicine, Los Angeles County-, University of Southern California Medical Center, and the University of Southern California School of Medicine, Los Angeles, California
Patricia Wohlford
Affiliation:
Departments of Hospital Epidemiology and Medicine, Los Angeles County-, University of Southern California Medical Center, and the University of Southern California School of Medicine, Los Angeles, California
*
Box 596, LAC-USC Medical Center, 1200 North State Street, Los Angeles, CA 90033
Get access Rights & Permissions [Opens in a new window]

Abstract

An outbreak of rubella in a large metropolitan hospital is described. Nineteen cases among employees and three secondary cases in family members occurred. Nosocomial cases occurred among the 3,900 employees of an adult medical-surgical unit where a voluntary program of rubella immunization was in effect. No cases occurred among the 1,400 employees of the women's and pediatric units with mandatory policies, despite interfacility and community exposure. Ten pregnant women were among the 377 contacts of the cases. Five were sero-negative to rubella. Two who developed clinical rubella, one asymptomatic sero-conversion and one other, all elected to terminate their pregnancies. The remaining woman, exposed in her third trimester delivered a normal infant. We conclude a policy requiring new employees to be rubella immune is more effective in preventing nosocomial rubella than a voluntary program and is desirable in view of the potential consequences of an outbreak to pregnant employees.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 6 , Issue 9 , September 1985 , pp. 371 - 374
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Polk, BF, White, JA, DeCirolami, PC, et al: An outbreak of rubella among hospital personnel. N Engl J Med 1980;303:541–545.Google Scholar
2.Strassburg, MA, Imagawa, DT, Fannin, SL, et al: Rubella outbreak among hospital employees. Obstet Gynecol 1981;57:283–288.Google Scholar
3.Division of Immunization, CDC: Rubella in hospitals—California. MMWR 1983;32:37–39.Google Scholar
4.Fliegel, PE, Weinstein, WM: Rubella outbreak in a prenatal clinic: Management and prevention. Am J Infect Control 1982;10:29–33.Google Scholar
5.Gladstone, JL, Millian, SJ: Rubella exposure in an obstetric clinic. Obstet Gynecol 1981;57:182–186.Google Scholar
6.Hartstein, AI, Quan, MA, Williams, ML, et al: Rubella screening and immunization of health care personnel: Critical appraisal of a voluntary program. Am J Infect Control 1983;11:1–9.Google Scholar
7.Witte, JJ, Karchmer, AW, Case, G, et al: Epidemiology of rubella. Am J Dis Child 1969;118:107–111.Google Scholar
8.Koplan, JP, White, CC: An update of the benefits and costs of measles and rubella immunization, in Proceedings of the symposium “Conquest of agents that endanger the brain,” Baltimore, Maryland, October 28-29, 1982, to be published.Google Scholar
9.Orenstein, WA, Bart, KJ, Hinman, AR, et al: The opportunity and obligation to eliminate rubella from the United States. JAMA 1984;251:1988–1994.Google Scholar
10.Division of Immunization, CDC: Rubella and congenital rubella—United States, 1983. MMWR 1984;33:237–247.Google Scholar
11.Current population reports. Population Characteristics. Fertility of American women 1976. Washington, D.C., Bureau of the Census, 1977, p 83.Google Scholar
12.Preblud, SR, Serdula, MK, Frank, JA Jret al: Rubella vaccination in die United States: A ten-year review. Epidemiologic Reviews 1980;2:171–194.Google Scholar
13.Surveillance and Investigations Section, CDC: Rubella and congenital rubella—United States, 1980-1983. MMWR 1983;32:505–510.Google Scholar
14.Haley, RW, Emori, TG: The employee health service and infection control in US hospitals, 1976-1977. I. Screening procedures. JAMA 1981;246:844–847.Google Scholar
15.Strassburg, MA, Stephenson, TG, Habel, LA, et al: Rubella in hospital employees. Infect Control 1984;5:123–126.Google Scholar
16.Orenstein, WA, Heseltine, PN, LeGagnoux, SJ, et al: Rubella vaccine and susceptible hospital employees. Poor physician participation. JAMA 1981;245:711–713.Google Scholar
17.American College of Obstetricians and Gynecologists: Rubella—a clinical update. Technical Bulletin Number 62. Chicago, ACOG, 1981.Google Scholar
18.Advisory Committee on Infections within Hospitals of the American Hospital Association. Recommendations for the control of rubella within hospitals. Chicago, American Hospital Association, 1981.Google Scholar
19.Advisory Committee on Immunization Practices: Rubella prevention. MMWR 1981;30:37-42, 47.Google Scholar