title: Prevalence of measles antibodies among health care workers in Catalonia (Spain) in the elimination era.
abstract: BACKGROUND
  Interruption of measles transmission was achieved in Catalonia (Spain) in 2000. Six years later, a measles outbreak occurred between August 2006 and June 2007 with 381 cases, 11 of whom were health care workers (HCW).The objective was to estimate susceptibility to measles in HCW and related demographic and occupational characteristics.
  
  
  METHODS
  A measles seroprevalence study was carried out in 639 HCW from six public tertiary hospitals and five primary healthcare areas. Antibodies were tested using the Vircell Measles ELISA IgG Kit. Data were analyzed according to age, sex, type of HCW, type of centre and vaccination history.The odds ratios (OR) and their 95% CI were calculated to determine the variables associated with antibody prevalence. OR were adjusted using logistic regression.Positive predictive values (PPV) and the 95% confidence intervals (CI) of having two documented doses of a measles containing vaccine (MCV) for the presence of measles antibodies and of reporting a history of measles infection were calculated.
  
  
  RESULTS
  The prevalence of measles antibodies in HCW was 98% (95% CI 96.6-98.9), and was lower in HCW born in 1981 or later, after the introduction of systematic paediatric vaccination (94.4%; 95% CI 86.4-98.5) and higher in HCW born between 1965 and 1980 (99.0%; 95% CI 97.0-99.8). Significant differences were found for HCW born in 1965-1980 with respect to those born in 1981 and after (adjusted OR of 5.67; 95% CI: 1.24-25.91).A total of 187 HCW reported being vaccinated: the proportion of vaccinated HCW decreased with age. Of HCW who reported being vaccinated, vaccination was confirmed by the vaccination card in 49%. Vaccination with 2 doses was documented in only 50 HCW, of whom 48 had measles antibodies. 311 HCW reported a history of measles.The PPV of having received two documented doses of MCV was 96% (95% CI 86.3-99.5) and the PPV of reporting a history of measles was 98.7% (95% CI 96.7-99.6).
  
  
  CONCLUSIONS
  Screening to detect HCW who lack presumptive evidence of immunity and vaccination with two doses of vaccine should be reinforced, especially in young workers, to minimize the risk of contracting measles and infecting the susceptible patients they care for.
authors: Public Health Agency, Generalitat of Catalonia, Barcelona, Spain. luis.urbiztondo@gencat.cat
authors: Luis
authors: L
authors: Urbiztondo
authors: Eva
authors: E
authors: Borràs
authors: Josep
authors: J
authors: Costa
authors: Sonia
authors: S
authors: Broner
authors: Magda
authors: M
authors: Campins
authors: José María
authors: JM
authors: Bayas
authors: María
authors: M
authors: Esteve
authors: Angela
authors: A
authors: Domínguez
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000914:Antibodies, Viral / Q000097:blood*; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000276:immunology* / Q000517:prevention & control; D008458:Measles Vaccine / Q000008:administration & dosage*; D008875:Middle Aged; D015233:Models, Statistical; D016017:Odds Ratio; D015995:Prevalence; D016036:Seroepidemiologic Studies; D013030:Spain / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D000914:Antibodies, Viral; D008458:Measles Vaccine
references: Am J Infect Control. 2009 Dec;37(10):858-60
references: 19608297
references: J Infect Dis. 2011 Jul;204 Suppl 1:S483-90
references: 21666204
references: BMC Infect Dis. 2010 Mar 11;10:62
references: 20219143
references: Euro Surveill. 2001 Jul;6(7):113-7
references: 12631955
references: MMWR Recomm Rep. 2011 Nov 25;60(RR-7):1-45
references: 22108587
references: Bull World Health Organ. 1997;75(4):367-75
references: 9342896
references: Euro Surveill. 2006;11(10):267-70
references: 17130659
references: Hum Vaccin Immunother. 2013 Mar;9(3):675-80
references: 23303107
references: Euro Surveill. 2010 Dec 16;15(50):
references: 21172176
references: Vaccine. 2012 Jun 8;30(27):3996-4001
references: 22521843
references: Scand J Infect Dis. 2002;34(6):426-9
references: 12160169
references: Infect Control Hosp Epidemiol. 2002 May;23(5):276-8
references: 12026154
references: Am J Infect Control. 2003 May;31(3):157-62
references: 12734521
references: Commun Dis Intell Q Rep. 2006;30(3):358-65
references: 17120490
references: J Hosp Infect. 2000 Feb;44(2):154-5
references: 10662570
references: Euro Surveill. 2011 Jan 13;16(2):
references: 21251488
references: Euro Surveill. 2008 Apr 17;13(16):
references: 18768120
references: Eur J Clin Microbiol Infect Dis. 2006 May;25(5):310-7
references: 16786377
references: Occup Med (Lond). 2003 Sep;53(6):398-402
references: 14514907
references: Euro Surveill. 2010 May 20;15(20):
references: 20504390
references: J Infect Dis. 2011 Jun 1;203(11):1517-25
references: 21531693
references: Epidemiol Infect. 2012 Sep;140(9):1599-606
references: 22074684
references: J Infect Dis. 2003 May 15;187 Suppl 1:S97-101
references: 12721899
references: Euro Surveill. 2008 Jul 24;13(30):
references: 18761910
references: Clin Infect Dis. 2008 Nov 1;47(9):1143-9
references: 18823269
references: MMWR Morb Mortal Wkly Rep. 2009 Feb 20;58(6):142-5
references: 19229166
references: MMWR Morb Mortal Wkly Rep. 2012 Jan 20;61(2):30-2
references: 22258416