61 Successful improvement in post-exposure outcomes among healthcare workers exposed to vaccine-preventable diseases in a hospital setting. (25th October 2019) - Fadlilmula, Abubaker Omer
Abstract : Background: Healthcare workers (HCWs) working in hospitals are at higher risk of exposure to patients with different infectious agents, particularly measles, mumps, rubella, and varicella. Identifying the HCWs who are at risk and initiating post-exposure management is critical to reduce the risk of further spread to other patients and HCWs. This is especially important in high- risk hospital areas such as emergency departments. The objective of the current study was to assess the impact of a multi- partner intervention on the outcomes of post-exposure management. Methods: All exposed HCWs working in King Abdullah Bin Abdulaziz Specialized Children's Hospital exposed to measles, rubella, mumps, and varicella during 2017 and 2018 were identified through active investigation and passive reporting. A multi- partner intervention was done during December 2017 to reduce the risk and outcome of exposure. Immune status of exposed HCWs as previously documented in the electronic records was evaluated. Those who were not sufficiently immune were given the relevant vaccine (MMR or varicella). Group and individual education was done to increase the awareness of HCWs. Engagement of departmental heads and nurse managers was pursued to encourage compliance. The outcomes of post-exposure management were compared before (2017) and after (2018) starting the intervention. Results: A total of 213 HCWs were exposed to the targeted infectious diseases (97 in 2017 and 116 in 2018). Of 213 HCWs, 41.3% were exposed to varicella, 41.3% to mumps, 8.9% to measles, and 8.5% to rubella. Compliance with post-exposure evaluation improved from 74.5% in 2017 to 95.0% in 2018. Although more HCWs were exposed to one of the above diseases in 2018 compared with 2017, the immune status of HCWs significantly increased from 69.4% in 2017 to 91.7% in 2018 (p<0.001). Cleared HCWs increased from 68.2% in 2017 to 90.1% in 2018 (p<0.001). Those who were granted sick leave decreased from 2.3% in 2017 to 0.7% in 2018 (p=0.573). Conclusion: A post-exposure intervention including immunization and awareness was successful at improving immunity and return to work rates, and reducing the need for sick leave. This intervention needs to be continuously implemented, especially in high-risk locations such as emergency departments. This can probably increase the safety of the work environment and reduce related absenteeism.