[Exanthemic diseases (measles, chickenpox, rubella and parotitis). Focus on screening and health surveillance of health workers: results and perspectives of a multicenter working group].
BACKGROUND
Nosocomial transmission of varicella-zoster virus, certain paramixovirus and rubivirus might pose a risk of morbidity for varicella (V), rubella (R), mumps (Mu) and measles (Me) in health care workers (HCW), patients and coworkers. International literature and European legislation recommend preventive interventions to minimize the risk.


METHODS
A literature review and a seroprevalence study were carried out in 9 hospitals located in north and central Italy, in order to evaluate risk assessment, health surveillance and fitness for work of HCW exposed to V, R, Mu and Me. Antibodies (Ab) against V, R, Mu and Me were determined. For a subgroup of 4 hospitals; sociodemographic, occupational data and sera were collected and analyzed.


RESULTS
About 36000 tests on about 9000 HCW were analyzed. Differences in seroprevalence ratios (V 85.7-95.1%, R 47-96.8%, Me 71.4-97.8%, Mu 52.5-87.6%) were detected. In a subgroup, a relevant number of non immune HCW was also found among women infertile age and areas at higher risk. Statistically significant differences were detected only for selected variables and viruses.


CONCLUSIONS
Data of multicenter study confirm literature evidences and allow to define good medical practices for manage and minimize the risk of nosocomial transmission of V, R, Me and Mu. Recommendation are issued about serologic screening on HCW exposed to all 4 viruses thorough the modern analytical techniques, in order to assess risk on individual a group basis and to select priorities for intervention. Vaccination should be prescribed for those HCW non immune, selecting areas and HCW according to priorities.
Sezione di Medicina del Lavoro ed Igiene Industriale, Università di Brescia, Italy.
M
M
Campagna
M
M
Bacis
L
L
Belotti
N
N
Biggi
P
P
Carrer
L
L
Cologni
V
V
Gattinis
V
V
Lodi
N
N
Magnavita
G
G
Micheloni
C
C
Negro
M
M
Oppini
D
D
Placidi
R
R
Polato
V
V
Puro
E
E
Tonelli
S
S
Porru
D002644:Chickenpox / Q000517:prevention & control*; D005076:Exanthema / Q000821:virology; D006282:Health Personnel; D006801:Humans; D008457:Measles / Q000517:prevention & control*; D009784:Occupational Diseases / Q000517:prevention & control*; D010309:Parotitis / Q000517:prevention & control*; D012409:Rubella / Q000517:prevention & control*