Harpreet Singh1, Kapil H Pandya2, V K Bhatti3, Sumit Lathwal4, M Kumar5. 1. Joint Director Medical Services (Ex-servicemen), O/o Director General Medical Services (Army), IHQ, Ministry of Defence, New Delhi, India. 2. Joint Director, Armed Forces Medical Services, O/o Director General Armed Forces Medical Services, IHQ, Ministry of Defence, New Delhi, India. 3. Director, Armed Forces Medical Services (Health), O/o Director General Armed Forces Medical Services, IHQ, Ministry of Defence, New Delhi, India. 4. Assistant Director (Health), Headquarters Delhi Area, India. 5. Professor (Pathology & Microbiology), Bharati Vidyapeeth Medical College. Pune 411043, India.
Abstract
Background: Adult and immunocompromised patients suffering from varicella (chicken pox) are potential source of infection to healthcare workers. An outbreak of varicella among healthcare workers in a tertiary care centre was investigated, and preventive measures were implemented. Methods: Cases of chicken pox between 05 Feb 2017 and 11 Feb 2017 in a tertiary healthcare establishment were investigated. An epidemiological investigation by developing case definitions, spot map and contact tracing was conducted. Eight cases were identified among healthcare workers. Suitable preventive measures including identification of susceptible contacts and vaccination of susceptible ones with two doses of varicella vaccine was undertaken. Results: Index case was a 21-year-old nurse who was exposed to a 34-year-old male patient transferred from a secondary care hospital on 24 Jan 2017 as a case of acute liver failure and coagulopathy. Primary case was later diagnosed as case of varicella based on serological and clinical evidence. Among a total of 8 cases identified in the outbreak, the cases occurred among healthcare workers of secondary care centre, healthcare workers managing the primary case in the intensive care unit and who conducted the autopsy. A total of 181 contacts were identified in the epidemiological investigation, and 54 were susceptible to chicken pox. Two-dose immunization with varicella vaccination of susceptible ones was found to be effective in preventing further cases. Conclusion: Two-dose vaccination of healthcare workers with varicella vaccine is an effective strategy to prevent nosocomial varicella among healthcare workers.
Background: Adult and immunocompromised patients suffering from varicella (chicken pox) are potential source of infection to healthcare workers. An outbreak of varicella among healthcare workers in a tertiary care centre was investigated, and preventive measures were implemented. Methods: Cases of chicken pox between 05 Feb 2017 and 11 Feb 2017 in a tertiary healthcare establishment were investigated. An epidemiological investigation by developing case definitions, spot map and contact tracing was conducted. Eight cases were identified among healthcare workers. Suitable preventive measures including identification of susceptible contacts and vaccination of susceptible ones with two doses of varicella vaccine was undertaken. Results: Index case was a 21-year-old nurse who was exposed to a 34-year-old male patient transferred from a secondary care hospital on 24 Jan 2017 as a case of acute liver failure and coagulopathy. Primary case was later diagnosed as case of varicella based on serological and clinical evidence. Among a total of 8 cases identified in the outbreak, the cases occurred among healthcare workers of secondary care centre, healthcare workers managing the primary case in the intensive care unit and who conducted the autopsy. A total of 181 contacts were identified in the epidemiological investigation, and 54 were susceptible to chicken pox. Two-dose immunization with varicella vaccination of susceptible ones was found to be effective in preventing further cases. Conclusion: Two-dose vaccination of healthcare workers with varicella vaccine is an effective strategy to prevent nosocomial varicella among healthcare workers.