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Screening Healthcare Workers for Varicella-Zoster Virus: Can We Trust the History?

Published online by Cambridge University Press:  02 January 2015

Maha Almuneef ,
Ziad A. Memish ,
Mostafa F. Abbas  and
Hanan H. Balkhy
Maha Almuneef
Affiliation:
Department of Infection Prevention and Control, King Abdulaziz Medical City-King Fahad National Guard Hospital Riyadh, Kingdom of Saudi Arabia Department of Pediatrics, King Abdulaziz Medical City-King Fahad National Guard Hospital Riyadh, Kingdom of Saudi Arabia
Ziad A. Memish*
Affiliation:
Department of Infection Prevention and Control, King Abdulaziz Medical City-King Fahad National Guard Hospital Riyadh, Kingdom of Saudi Arabia Department of Internal Medicine, King Abdulaziz Medical City-King Fahad National Guard Hospital Riyadh, Kingdom of Saudi Arabia
Mostafa F. Abbas
Affiliation:
Department of Infection Prevention and Control, King Abdulaziz Medical City-King Fahad National Guard Hospital Riyadh, Kingdom of Saudi Arabia
Hanan H. Balkhy
Affiliation:
Department of Infection Prevention and Control, King Abdulaziz Medical City-King Fahad National Guard Hospital Riyadh, Kingdom of Saudi Arabia Department of Pediatrics, King Abdulaziz Medical City-King Fahad National Guard Hospital Riyadh, Kingdom of Saudi Arabia
*
Adult Infectious Diseases, Department of Medicine and Executive Director, Infection Prevention & Control Program, King Abdulaziz Medical City-King Fahad National Guard Hospital, National Guard Health Affairs, P.O. Box 22490, Riyadh 11426, Kingdom of Saudi Arabia
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Abstract

Objective:

To determine the relationship between immunity and a history of chickenpox based on a self-administered questionnaire.

Methods:

We investigated immunity to varicella-zoster virus in a cohort of newly recruited employees with different job categories and different nationalities using enzyme-linked immunosorbent assay IgG.

Results:

There were 1,058 new recruits. Of these, 890 (84%) were immune and 168 (16%) were susceptible. The susceptibility rate was 23% (n = 77) for Asian, 15% (n = 14) for South African, 13% (n = 66) for Middle Eastern, and 9% (n = 11) for Western employees. Physicians were more likely to be immune (93%) than were nurses (85%), medical technicians (75%), or administrative clerks (84%). Seropositivity was not affected by age or gender. The positive predictive value of a history of chickenpox for the seropositivity was 89% (511 of 574); the negative predictive value was 22% (105 of 484). History of chickenpox had a sensitivity of 57% (511 of 890) and a specificity of 63% (105 of 168).

Conclusions:

The varicella-zoster virus seroprevalence among new employees was low, posing an important risk to existing employees and patients. Positive or negative history of chickenpox was an unreliable indicator of susceptibility among healthcare workers of different nationalities. Serologic screening of all employees and vaccination of those susceptible was recommended.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 7 , July 2004 , pp. 595 - 598
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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