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Hospital Experience with Varicella-Zoster Virus

Published online by Cambridge University Press:  02 January 2015

Keith Krasinski*
Affiliation:
Departments of Pediatrics, Internal Medicine, and Nursing, New York University Medical Center and Bellevue Hospital Center, New York, New York
Robert S. Holzman
Affiliation:
Departments of Pediatrics, Internal Medicine, and Nursing, New York University Medical Center and Bellevue Hospital Center, New York, New York
Rita LaCouture
Affiliation:
Departments of Pediatrics, Internal Medicine, and Nursing, New York University Medical Center and Bellevue Hospital Center, New York, New York
Alfred Florman
Affiliation:
Departments of Pediatrics, Internal Medicine, and Nursing, New York University Medical Center and Bellevue Hospital Center, New York, New York
*
Department of Pediatrics, New York University Medical Center, 550 First Avenue, New York, NY 10016

Abstract

Varicella-zoster virus (VZV), one of the most common highly communicable agents of disease, stimulates aggressive infection control measures. In a 1-year period, at one hospital, at least 93 inpatients (82 adult patients, 11 pediatric patients) and 2 hospital staff with active varicella-zoster infections served as potential sources of nosocomial infection. Six incidents of exposure to the virus that occurred without the protection of standard infection control precautions were investigated by the infection control surveillance team. One hundred fifty-six patients and 353 hospital staff were exposed. Fifty-one patients had no history of varicella-zoster infection, but only five were susceptible by serologic testing. One hundred one staff members had no history of varicella-zoster, but only 11 were susceptible by serologic testing. These exposures resulted in three secondary varicella-zoster infections, six courses of varicella-zoster immune globulin prophylaxis and furlough of 13 staff members. Epidemiologic investigation consumed approximately 356 hours of staff time, and management of exposed persons cost approximately $41,500. Prospective knowledge of the immune status of health care workers would vastly decrease the time and effort required to control hospital VZV exposures.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

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References

1. Hope-Simpson, RE: Infectiousness of communicable diseases in the household (measles, mumps and chickenpox). Lancet 1952; 2:549.Google Scholar
2. Garner, JS, Simmons, BP: Guidelines for isolation precautions in hospitals. Infect Control 1983; 4:245249.Google Scholar
3. Myers, MG, Rasley, DA, Hierholzer, WJ: Hospital infection control for varicella zoster virus infection. Pediatrics 1982; 70:199201.Google Scholar
4. Williams, V, Gershon, AA, Brunell, PA: Serologic response to varicella-zoster membrane antigens measured by indirect immunofluorescence, J Infect Dis 1974; 130:669672.Google Scholar
5. Gershon, AA, Frey, HM, Steinberg, SP, et al: Determination of immunity to varicella using an enzyme-linked immunosorbent assay. Arch Virol 1981; 70:169172.Google Scholar
6. Gustafson, TL, Lovely, GB, Brawner, ER Jr, et al: An outbreak of airborne nosocomial varicella. Pediatrics 1982; 70:550556.Google Scholar
7. Thomson, FH, Aberd, CM: The aerial conveyance of infection with a note on the contact infection of chicken-pox. Lancet 1916; 1:341344.Google Scholar
8. LeClair, JM, Zaia, JA, Levin, MJ, et al: Airborne transmission of chickenpox in a hospital. N Engl J Med 1980; 302:450453.Google Scholar
9. Meyers, JD, MacQuarrie, MB, Merigan, TC, et al: Nosocomial varicella. Part I: Outbreak in oncology patients at a children's hospital. West J Med 1979; 130:196199.Google Scholar
10. Gordon, JE, Meader, FM: The period of infectivity and serum prevention of chickenpox. JAMA 1929; 93:20132015.Google Scholar
11. Florman, AL, Umland, ET, Ballou, MS, et al: Evaluation of a skin test for chickenpox. Infect Control 1985; 8:314316.Google Scholar
12. Gershon, AA, Steinberg, S, Brunell, PA: Zoster immune globulin: A further assessment. N Engl J Med 1974; 290:243245.Google Scholar
13. Gershon, AA: The success of varicella vaccine. Pediatr Infect Dis 1984; 3:500502.Google Scholar
14. Katsushima, N, Yazaki, N, Sakamoto, M, et al: Application of a live varicella vaccine to hospitalized children and its follow-up study. Biken J 1982; 25:2942.Google Scholar
15. Gershon, AA, Steinberg, SP, Gelb, L, et al: Live attenuated varicella zoster. JAMA 1984; 252:355362.Google Scholar
16. Preblud, SR: Age-specific risks of varicella complications. Pediatrics 1981; 68:1417.Google Scholar
17. Preblud, SR, D'Angelo, LJ: Chickenpox in the United States 1972-1977. J Infect Dis 1979; 140:257259.Google Scholar
18. Gershon, AA: Varicella-zoster infections, in Krugman, S, Katz, SL, Gershon, AA, et al (eds): Infectious Diseases of Children. (8th ed) St. Louis, CV Mosby Co, 1985, p 444.Google Scholar
19. Young, NA, Gershon, AA: Chickenpox, measles and mumps, in Remington, JS, Klein, JO (eds): Infectious Diseases of the Fetus and Newborn Infant. (2nd Ed) Philadelphia, WB Saunders Co, 1983, pp 375427.Google Scholar
20. Schimpff, S, Serpick, A, Stoler, B, et al: Varicella-zoster infection in patients with cancer. Ann Intern Med 1972; 76:241254.Google Scholar