Serosurvey on healthcare personnel caring for patients with Ebola virus disease and Lassa virus in the United States.

OBJECTIVE: Healthcare personnel (HCP) were recruited to provide serum samples, which were tested for antibodies against Ebola or Lassa virus to evaluate for asymptomatic seroconversion. SETTING: From 2014 to 2016, 4 patients with Ebola virus disease (EVD) and 1 patient with Lassa fever (LF) were treated in the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital. Strict infection control and clinical biosafety practices were implemented to prevent nosocomial transmission of EVD or LF to HCP. PARTICIPANTS: All personnel who entered the SCDU who were required to measure their temperatures and complete a symptom questionnaire twice daily were eligible. RESULTS: No employee developed symptomatic EVD or LF. EVD and LF antibody studies were performed on sera samples from 42 HCP. The 6 participants who had received investigational vaccination with a chimpanzee adenovirus type 3 vectored Ebola glycoprotein vaccine had high antibody titers to Ebola glycoprotein, but none had a response to Ebola nucleoprotein or VP40, or a response to LF antigens. CONCLUSIONS: Patients infected with filoviruses and arenaviruses can be managed successfully without causing occupation-related symptomatic or asymptomatic infections. Meticulous attention to infection control and clinical biosafety practices by highly motivated, trained staff is critical to the safe care of patients with an infection from a special pathogen.

Smallpox vaccination--implications for the occupational health professional.

Because of the announcement of the ACIP recommendation on December 13, 2002 and the commencement of the smallpox vaccine program at various facilities nationally, adverse events data are being carefully analyzed by CDC researchers. As previously discussed, CDC recommend a cardiac risk profile be included in the pre-event vaccination screening criteria. A definitive link between the onset of myopericarditis and the smallpox vaccine is suspected, but under investigation. The CDC ascertains there is uncertain evidence of any association between ischemic heart disease and vaccinia (CDC, 2003c). As the pre-event vaccine program expands, occupational health professionals should be cognizant of changes to the smallpox vaccine recommendations and modify their policies and protocols appropriately.

Cytotoxic drug handlers--monitoring in the occupational health setting.

Many advances have been made in the area of cytotoxic drug handling among health care workers. The publication of technical guidelines in the late 1980s and early 1990s have served a fundamental role in increasing awareness of the potential risk to health care workers exposed to cytotoxic agents. The OSHA and ASHP guidelines have greatly assisted occupational health professionals in developing appropriate policy for their hospital institution. However, with their use during the years, the guidelines have been criticized as impractical and not very useful. Occupational health professionals welcome the changes on the horizon as research uncovers new and better ways to monitor high risk employees.