Vaccine-preventable diseases and medical personnel

Article Abstract:

Nosocomial infections are those acquired during hospitalization. Hospital personnel are required to be immunized or show proof of immunization against vaccine-preventable diseases such as measles, mumps and rubella. In some hospitals, physicians and medical students are not subject to the same requirements. Hospital epidemics of these preventable diseases could be costly and disastrous. A report in the January 1990 issue of Archives of Internal Medicine concerns two studies dealing with vaccine-preventable diseases in hospitals. Many medical schools do not have policies regarding immunization of medical students. This, in combination with the five percent failure rate of the vaccine, supports routine blood screening of all medical personnel. Although unvaccinated children are a major source of measles, 71 colleges reported at least one case in 1989. It is suggested that all individuals born after 1956 be tested for immunity (most people born before 1956 acquired immunity from actually contracting the disease). There is a potential for epidemic of the mumps virus because past immunizations may no longer protect against the disease. One study revealed that five to seven percent of medical students in one university lacked immunity to the mumps virus. Vaccinations for tetanus and diphtheria toxoid should also be current. Tests should be given to determine which adults are not immune to the varicella-zoster virus (chickenpox), as infections in adults can be serious. Personnel should also be protected from hepatitis B virus infections. Documentation regarding proof of immunity of vaccine-preventable diseases should be required of all medical personnel. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Communicable diseases, Vaccination, Disease transmission

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What should we do about HIV-positive health professionals?

Article Abstract:

A recent conference entitled 'The HIV+ Health Professional: Policy Options for Individuals, Institutions, and States,' addressed issues regarding current policies on health care workers who test positive for HIV, the virus that causes AIDS. The recent case of a dentist's transmission of the AIDS virus to several of his patients was the first documentation that such transmission can occur. The risk of transmission from practitioner to patient is extremely low, and this must be emphasized. 'Zero risk' of AIDS virus transmission to patients by infected health care workers can never be achieved. Mandating that infected health care workers inform their patients of their HIV-positive status is not appropriate, because either the risk of transmission is so slight as to not justify the damage to the practitioner's career and well-being, or else the risk is significant enough that the practitioner should not engage in practice at all, in which case mere disclosure is inadequate. This opinion of the conference attenders differed from the recently announced recommendations of both the American Medical Association and the American Dental Association, which state that infected practitioners should warn their patients or withdraw from practice. Representatives of the Centers for Disease Control (CDC) were invited to attend the conference, but declined, due to the sensitivity of their political positions. Thus, recommendations by the CDC concerning HIV-infected health care workers are awaited. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Social policy, American Dental Association, American Medical Association, HIV patients, Civil rights

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Protecting tomorrow's health care professionals against hepatitis B virus today

Article Abstract:

Hepatitis B virus (HBV), which can cause chronic and sometimes fatal liver disease, is a known occupational hazard for those in the health professions. A vaccine to prevent this illness does exist, but only 34 to 40 percent of those health care workers at risk of exposure to the disease have received the vaccine. Students in health professional schools are also at risk of contracting HBV. Currently, only 4 percent of nursing schools require HBV vaccination, and only 8 percent recommend it. Over 90 percent of medical schools recommend the vaccine to their students, but only 17 percent report that over 95 percent of their students have received the vaccine. Cost may be a significant factor preventing health care students from receiving HBV vaccine, with the series of three injections required costing from $150 to $200. Requiring the vaccine before admission, or providing it free of cost, are two options that health profession schools can consider to increase the number of health care students protected against HBV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Prevention, Medical students, Hepatitis B

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