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Parvovirus B19 outbreak on an adult ward

Published online by Cambridge University Press:  15 May 2009

C. Seng*
Affiliation:
PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
P. Watkins
Affiliation:
Department of Medical Microbiology and Virology, St Mary's Hospital Medical School, London W2
D. Morse
Affiliation:
PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
S. P. Barrett
Affiliation:
Department of Medical Microbiology and Virology, St Mary's Hospital Medical School, London W2
M. Zambon
Affiliation:
Department of Medical Microbiology and Virology, St Mary's Hospital Medical School, London W2
N. Andrews
Affiliation:
PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
M. Atkins
Affiliation:
Department of Medical Microbiology and Virology, St Mary's Hospital Medical School, London W2
S. Hall
Affiliation:
PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
Y. K. Lau
Affiliation:
Department of Public Health Medicine, Kensington, Chelsea and Westminster District Health Authority, 16 South Wharf Rd, London W2 1NY
B. J. Cohen
Affiliation:
Virus Reference Division, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5EQ
*
* Author for correspondence: Dr C. Seng, Brent and Harrow Health Agency, Grace House, Bessborough Road, Harrow HA1 3EX.
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In November and December 1992, an outbreak of parvovirus B19 infection occurred among patients and staff on an adult mixed surgical ward at a large hospital in London. Three patients and 15 staff members were serologically confirmed as acute cases. The attack rate among susceptible members of staff was 47%. In those infected, arthralgia (80%) and rash (67%) were the most common symptoms. Of six susceptible in-patients on the ward, three became infected. One of the in-patients who had carcinoma of the mouth was viraemic for more than 10 days with marrow suppression resulting in the postponement of chemotherapy until intravenous immunoglobulin was given and he was no longer viraemic. Control measures taken included closure of the ward to new admissions, transfer of only immune staff to the ward, and restriction of the ward nursing staff to working only on that ward. Although no specific exposure was conclusively identified as a risk factor, there was a suggestion of an increased risk of acquiring parvovirus B19 infection among those staff who did not adopt strict hand washing procedures after each physical contact with a patient (RR = 2·33; P = 0·07). Knowledge of parvovirus B19 among interviewed health care workers was poor: only 42% reported knowing about parvovirus B19 and only 38% could name a patient category at risk of a severe outcome following infection. This is the first report of a nosocomial outbreak affecting an adult ward and of possible transmission of parvovirus B19 infection from staff to in-patients. Hospital control of infection teams should include parvovirus B19 in their outbreak containment plans.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1994

References

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