Human parvovirus B19 nosocomial outbreak in healthcare personnel in a paediatric ward at a national tertiary referral centre in Thailand.

BACKGROUND: Nosocomial outbreaks of parvovirus B19 (pB19) have been reported, but they rarely occur among healthcare personnel (HCP). Susceptibility among pregnant HCP was the major concern. METHODS: An outbreak of pB19 among HCP is described in a paediatric ward with a cross-sectional serologic study in all HCP and patients exposed to the outbreak. Acute infection was diagnosed by polymerase chain reaction or positive anti-parvovirus B19 IgM. FINDINGS: Among 48 HCP (three pregnant) and 22 patients included in the outbreak serologic study, 11 (23%) HCP and two (9%) patients had acute infection. Of these, six HCP and no patients were symptomatic. Clinical manifestations included itchy rash (100%) and joint pain following resolution of rash (67%), with median rash duration of four days. Forty percent of HCP and 50% of patients had positive anti-parvovirus IgG, indicating previously immune status. HCP with acute infection and HCP who were susceptible without infection were younger than HCP with previous immunity (mean age 32.2 vs 40.5 years, respectively; P = 0.003). The attack rate was 38% among HCP and 18% among patients who were susceptible, respectively. The outbreak ended within two weeks following strict droplet precaution and segregation of symptomatic HCP. CONCLUSION: Parvovirus B19 infection may cause nosocomial outbreak with high attack rate among HCP. Outbreak control with droplet precaution was highly effective.

Infusion-related phlebitis.

The incidence rate and risk factors of infusion-related phlebitis was studied in 1993. Thirty-five hospitals were enrolled. Data were collected from 6,256 infusion sites. Male and female patients were almost equal. Forearms were the commonest site of infusion, followed by hand and arm respectively. In 34.1 per cent the infusion was interrupted by complications of which 6.2 per cent was phlebitis. It was mild in most cases. Increased incidence rates of infusion related phlebitis were associated with: the use of plastic cannulas, dextrose containing solutions, administration at the sites other than hand and concomitant administration of antimicrobials. The incidence rate of phlebitis rose sharply after 24 hours of infusion. It is concluded that in addition to proper insertion and good nursing care, the avoidance of the above risk factors will lead to a lower incidence of infusion-associated phlebitis.

Microbiological quality of drinking water and using water of a Chao Phya River community, Bangkok.

Safe water is essential for good health of humans. The contamination of water with infected fecal material is common in areas with poor standards of hygiene and sanitation. The determination of microbiological quality of water is essential. Simple routine testing of the bacteriological quality of drinking water is designed to detect the presence of coliform bacteria and virological assessment is to detect the presence of enteric viruses, especially hepatitis A virus (HAV). Therefore, this study attempted to determine the HAV and coliform bacteria contamination in drinking water and using water of a Chao Phya River community, Bangkok where crowded living conditions increase the risk of water-related diseases. 95 samples of drinking water and 75 samples of used water in containers were collected with sterile technique for determining HAV antigen by ELISA and coliform contamination by the Most Probable Number Technique (MPN). The results revealed that HAV and coliform contamination rates of drinking water were 25.26% and 64.21%, respectively. The rain water had the highest contamination (60.00% and 80.00%). Tap water was 23.73% for HAV (14/59 samples) and 64.41% for coliforms (38/59 samples) whereas running water had the least contamination (2.94% for HAV and 5.88% for coliforms). The contamination rates of used water were 10.69% for HAV and 68.67% for coliforms.