Viral infections in pregnancy: advice for healthcare workers.
BACKGROUND
Healthcare workers (HCWs) have the potential for increased exposure to infectious disease resulting from the provision of patient care. Pregnancy can confer specific problems in some infections for the mother and her unborn child.


OBJECTIVE
To discuss the viral infections encountered in the UK that constitute a particular risk to the pregnant HCW: human immunodeficiency virus, hepatitis B virus, hepatitis C virus, varicella-zoster virus, herpes simplex virus, human parvovirus B19, cytomegalovirus, rubella, measles, enteroviruses, mumps and influenza. Evidence for nosocomial transmission, clinical aspects specific to pregnancy, and recommendations to protect the pregnant HCW at work are included.


METHODS
Medline, EMBASE and Pubmed were searched using a list of keywords specific to each viral infection, including 'nosocomial', 'occupational' and 'healthcare workers'. References from the bibliographies of articles identified were reviewed for relevant material.


RESULTS
The evidence for increased risk in the healthcare setting for many of these infections, outside of outbreaks, is weak, possibly because of the application of standard protective infection control measures or because risk of community exposure is greater. The pregnant HCW should be advised on protective behaviour in both settings. Potential interventions include vaccination and reducing the likelihood of exposure through universal precautions, infection control and redeployment.


CONCLUSIONS
Protection of the pregnant HCW is the responsibility of the individual, antenatal care provider and employer, and is made possible through awareness of the risks and potential interventions both before and after exposure. If exposure occurs or if the HCW develops an infective illness, urgent specialist advice is required.
Southmead Hospital, North Bristol NHS Trust, Bristol, UK. Electronic address: lichin@doctors.org.uk.
T L
TL
Chin
Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
A P
AP
MacGowan
Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
S K
SK
Jacobson
Public Health England, Bristol Public Health Laboratory, Department of Virology, Bristol, UK.
M
M
Donati
D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D005260:Female; D006282:Health Personnel; D006801:Humans; D016273:Occupational Exposure; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000821:virology*; D006113:United Kingdom / Q000453:epidemiology; D014777:Virus Diseases / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission / Q000821:virology*; D014780:Viruses / Q000145:classification* / Q000302:isolation & purification*
Healthcare associated; Healthcare worker; Nosocomial; Occupational; Pregnant