title: Seroprotection to vaccine-preventable diseases among workers at a Victorian tertiary hospital.
abstract: OBJECTIVE
  To determine seroprotection for the vaccine-preventable diseases (VPDs) measles, mumps, rubella, varicella and hepatitis B among new employees seen at a Victorian tertiary hospital staff clinic.
  
  
  METHODS
  Employees who presented to the staff clinic for immunisation assessment between 1 January 2012 and 31 December 2013 were included. Demographic data, self-reported disease history and previous vaccination status were reviewed retrospectively to determine impact on serological results.
  
  
  RESULTS
  A total of 1,901 new employees were included, 83% of whom were at risk of direct contact with blood or body substances. Overall, the proportion of workers seropositive to measles was 88%, mumps 90%, rubella 78%, varicella 93% and hepatitis B 80%. Staff born before 1966 were more likely to have positive measles or mumps serology but negative rubella or hepatitis B serology (p<0.05 for each). Staff who self-reported measles (99% vs. 93%, p=0.03) or varicella infection (98% vs. 92%, p<0.001) were more likely to be seropositive, but those reporting previous vaccination to measles, mumps or rubella were no more likely to be seropositive.
  
  
  CONCLUSIONS
  This study demonstrated levels of seropositivity of 78-93% for the five VPDs. Despite recognised limitations of serological testing, 10-20% of new employees to a healthcare institution lacking seroprotection represents a potentially unacceptable risk of nosocomial transmission of these VPDs. Our findings support ongoing serological testing of new healthcare staff at risk of direct contact with blood or body substances.
authors.affiliation: Victorian Infectious Disease Service, Royal Melbourne Hospital at the Doherty Institute for Infection and Immunity, Victoria.
authors.forename: Eden C
authors.initials: EC
authors.lastname: Andrew
authors.affiliation: Victorian Infectious Disease Service, Royal Melbourne Hospital at the Doherty Institute for Infection and Immunity, Victoria.|Department of Epidemiology and Preventive Medicine, Monash University, Victoria.
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Gibney
authors.affiliation: Victorian Infectious Disease Service, Royal Melbourne Hospital at the Doherty Institute for Infection and Immunity, Victoria.|Department of Microbiology and Immunology, University of Melbourne, Victoria.
authors.forename: Justin
authors.initials: J
authors.lastname: Denholm
authors.affiliation: Victorian Infectious Disease Service, Royal Melbourne Hospital at the Doherty Institute for Infection and Immunity, Victoria.|Department of Epidemiology and Preventive Medicine, Monash University, Victoria.
authors.forename: Karin
authors.initials: K
authors.lastname: Leder
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002644:Chickenpox / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D003428:Cross Infection / Q000097:blood / Q000517:prevention & control*; D005260:Female; D006282:Health Personnel; D006509:Hepatitis B / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D012327:RNA Virus Infections / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D016036:Seroepidemiologic Studies; D062606:Tertiary Care Centers; D014611:Vaccination; D014739:Victoria / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral
keywords: immunisation; nosocomial infection; vaccination; vaccine-preventable diseases