Summary
All reports of hepatitis A (HA) outbreaks in healthcare settings published between
1975 and 2003 were studied to determine the background immunity or susceptibility
of healthcare workers (HCWs) to HA. Twenty-six reports were found. The number of infected
personnel ranged from one to 66 and, in most outbreaks, nurses accounted for the majority
of personnel infected, reflecting high attack rates reaching 15–41%. In addition,
we found 23 sero-epidemiological studies for HA among HCWs that had been performed
in 13 different countries. Seroprevalence rates of HCWs with anti-HA antibody ranged
between 4% among paramedical workers in Germany to 88% among hospital maintenance
workers in Portugal. Effective infection control of HA outbreaks in hospitals demands
early recognition, including awareness of atypical presentations of the infection,
and strict adherence to universal infection control measures. Education programmes
are of special importance for HCWs in neonatal, paediatric and intensive care units.
The findings of the current study suggest that a pre-employment screening policy and
administration of active vaccination to susceptible HCWs, particularly nurses, should
be seriously considered in high-risk settings.
Keywords
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© 2005 The Hospital Infection Society. Published by Elsevier Inc. All rights reserved.
