Seroprevalence Survey of Varicella, Measles, Rubella, and Hepatitis A and B Viruses in a Multinational Healthcare Workforce in Saudi Arabia

Objective.To determine the prevalence of the vaccine-preventable diseases caused by varicella, measles, rubella, and hepatitis A and B viruses in a multinational healthcare workforce.Design.Prospective cohort study.Setting.A 750-bed tertiary care center located in Riyadh, Saudi Arabia.Methods.In compliance with hospital policy, newly recruited healthcare workers (HCWs) were enrolled in the study from September 2001 to March 2005. Serum samples were collected from all HCWs during the initial hiring process and tested for IgG antibodies against each of the 5 viral agents. Nonimmune HCWs were subsequently vaccinated at the earliest opportunity.Results.A total of 4,006 newly hired (international and local) employees were included in the study. All underwent serologic testing for IgG antibodies against varicella, measles, rubella, hepatitis A, and hepatitis B viruses. Of the total, 63% were female and 37% were male. Middle Eastern employees comprised 47% of the total, followed by employees from the Far East (35%), the West (10%), and Africa (8%). Forty-two percent were nurses, 27% were in administration, 18% were medical technicians, and 13% were physicians. Among the 4,006 newly hired HCWs, 14% had negative IgG antibody test results for varicella virus, 13% for measles virus, 10% for rubella virus, 33% for hepatitis A virus, and 43% for hepatitis B virus. More women than men were susceptible to hepatitis A (40% vs. 24%;P< .001), whereas more men were susceptible to hepatitis B (55% vs. 35%;P< .001). Varicella susceptibility was more common among HCWs from the Far East (19%), whereas susceptibility to measles, rubella, hepatitis A, and hepatitis B was highest among HCWs from the Middle East. Both relative youth and male sex were associated with lack of antibodies against hepatitis B virus and rubella virus. In contrast, female sex and younger age were associated with lack of antibodies against hepatitis A virus (P< .001).Conclusion.Seroprevalence surveys of vaccine-preventable diseases among HCWs, although labor intensive, are invaluable in caring for a multinational workforce.

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Medical and Nursing Students with Suboptimal Protective Immunity against Vaccine-Preventable Diseases

Infection Control and Hospital Epidemiology ◽

10.1086/605923 ◽

2009 ◽

Vol 30 (10) ◽

pp. 1006-1011 ◽

Cited By ~ 14

Author(s):

Ioanna D. Pavlopoulou ◽

George L. Daikos ◽

Andreas Tzivaras ◽

Evangelos Bozas ◽

Chris Kosmidis ◽

...

Keyword(s):

Nursing Students ◽

Hepatitis B ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Hospital Setting ◽

Vaccine Preventable Diseases ◽

Healthcare Students ◽

B Virus ◽

Vaccination History ◽

History Of

Objectives.Medical and nursing students (hereafter referred to as “healthcare students”) are at risk of contracting and transmitting infectious diseases in a hospital Setting. The aim of our study was to evaluate the vaccination history of healthcare students and their serologic immunity against vaccine-preventable diseases.Design.Prospective cohort study.Setting.A tertiary care children's hospital in Athens, Greece, which is affiliated with the University of Athens.Methods.Healthcare students were recruited during April through November 2007. The information obtained from these students during personal interviews included demographics and whether there was a history of varicella, measles, mumps, rubella, and/or hepatitis A or B virus infection. Vaccination history and documentation of disease were abstracted from available medical records. Serum antibodies against the above-mentioned viral agents were determined by use of an enzyme-linked immunosorbent assay. Seronegative students and those with immunization gaps were referred to local vaccination clinics, and compliance was assessed 3 months later.Results.A total of 187 healthcare students were recruited, 131 (70.1%) of whom provided complete documentation of vaccination history. Adequate immunity against diphtheria and tetanus was documented for 55 (37.2%) and 73 (49.3%) of the 148 participants, respectively, whereas age-appropriate vaccination against pertussis, diphtheria, tetanus, and poliomyelitis was noted for 138 (93.2%), 147 (99.3%), 147 (99.3%), and 147 (99.3%) healthcare students, respectively. Of 185 healthcare students, 171 (92.4%) were immune to varicella. Of 182 healthcare students, 179 (98.4%) were immune to measles, 163 (89.6%) were immune to mumps, and 176 (96.7%) were immune to rubella. Of 179 healthcare students, 151 (84.4%) were immune to hepatitis B virus. Of 178 healthcare students, 26 (14.6%) were immune to hepatitis A virus. Antibodies (10 IU/L or higher) to hepatitis B surface antigen were detected for 151 (84.4%) of 179 healthcare students, and antibodies (10 IU/L or higher) to hepatitis A virus were detected for 26 (14.6%) of 178 healthcare students. Fewer than 30% of participants were in full compliance with recommended vaccinations.Conclusions.We have determined that there is a certain proportion of healthcare students who are susceptible to certain vaccine-preventable diseases. The development of an appropriate vaccination strategy is required to decrease the risk of transmission in a hospital setting.

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Viral Hepatitis: 1985 Update

Pediatrics in Review ◽

10.1542/pir.7.1.3 ◽

1985 ◽

Vol 7 (1) ◽

pp. 3-11

Author(s):

Saul Krugman

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Viral Hepatitis ◽

Hepatitis A ◽

Viral Infections ◽

Hepatitis A Virus ◽

Fatal Outcome ◽

Specific Marker ◽

Hepatitis D ◽

B Virus

During the past two decades extraordinary advances in hepatitis research have clarified the etiology and natural history of the disease. At least four types of hepatitis have been identified: A, B, D (delta), and non-A, non-B. Hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis D virus (HDV) have been characterized. Serologic tests have been developed to detect the antigens and antibodies associated with these three hepatitis infections. As of the present time, the non-A, non-B viral agents have not been identified. Therefore, non-A, non-B hepatitis is diagnosed by excluding other viral causes of hepatitis, such as hepatitis A virus, hepatitis B virus, Epstein-Barr virus (EBV), cytomegalovirus (CMV), and others. A recent report indicating that non-A, non-B hepatitis may be caused by a retrovirus, if confirmed, may provide a specific marker of this infection. The course of viral hepatitis is variable; it may be an asymptomatic, anteric infection, or it may be an acute illness characterized by fever, malaise, anorexia, nausea, abdominal pain, and jaundice. Most patients recover completely, but occasionally the infection may be complicated by chronic hepatitis, cirrhosis, and, occasionally, by a fulminant fatal outcome. This review will be devoted predominantly to a discussion of the diagnostic and prophylactic aspects of hepatitis A and hepatitis B viral infections.

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Prolonged and biphasic acute hepatitis A in hepatitis B virus carrier

Italian Journal of Medicine ◽

10.4081/itjm.2016.571 ◽

2016 ◽

Vol 10 ◽

Cited By ~ 1

Author(s):

Elena Garlatti Costa ◽

Michela Ghersetti ◽

Silvia Grazioli ◽

Pietro Casarin

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Acute Hepatitis ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Inactive Carrier ◽

B Virus ◽

Acute Hepatitis A ◽

Hepatitis B Virus Carrier ◽

Life Threatening

Acute hepatitis A is generally a self-limited disease in healthy subjects within few weeks, but an uncommon type of prolonged and biphasic acute course of hepatitis A infection has been also described. This type of presentation is observed in about 6-10% of patients, but a small number of reports, concerning this topic, are available in literature. In addition hepatitis A virus (HAV) infection in hepatitis B virus (HBV) carriers has rarely been discussed. A 41-year-old Italian man, already known to our Department for HBV infection as an inactive carrier HBsAg(+)ve, experienced a prolonged and biphasic course of acute hepatitis A, lasting about 7 months. In this patient possible factors, causing the second flare of transaminases, were excluded (in particular autoimmunity). Liver biopsy as well HAV RNA search in blood/stools were not performed. In conclusion, the hepatologist should take into account this type of atypical course in patients with HAV-related hepatitis and should promote HAV vaccination in subjects with HBV-chronic hepatitis, to prevent possible life-threatening acute exacerbation of hepatic damage, mainly in HBV-carriers with more severe forms of liver diseases.

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Prevalence of hepatitis A virus and hepatitis B virus immunity in patients with polymerase chain reaction-confirmed hepatitis C: implications for vaccination strategy

The American Journal of Gastroenterology ◽

10.1111/j.1572-0241.2001.03633.x ◽

2001 ◽

Vol 96 (3) ◽

pp. 858-863 ◽

Cited By ~ 37

Author(s):

Firdous Siddiqui ◽

Milton Mutchnick ◽

Joseph Kinzie ◽

Rene Peleman ◽

Paul Naylor ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Hepatitis C ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Vaccination Strategy ◽

Chain Reaction ◽

B Virus ◽

Polymerase Chain

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Classification of Hepatitis A Virus as Enterovirus Type 72 and of Hepatitis B Virus as Hepadnavirus Type 1

Intervirology ◽

10.1159/000149313 ◽

1982 ◽

Vol 18 (3) ◽

pp. 105-106 ◽

Cited By ~ 60

Author(s):

Joseph L. Melnick

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Hepatitis A ◽

Hepatitis A Virus ◽

B Virus ◽

Enterovirus Type

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Non-A, non-b hepatitis in chimpanzees: Interference with acute hepatitis A virus and chronic hepatitis B virus infections

Journal of Medical Virology ◽

10.1002/jmv.1890110304 ◽

1983 ◽

Vol 11 (3) ◽

pp. 207-213 ◽

Cited By ~ 60

Author(s):

Daniel W. Bradley ◽

James E. Maynard ◽

Karen A. McCaustland ◽

Bert L. Murphy ◽

E. H. Cook ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Virus Infections ◽

Chronic Hepatitis B Virus ◽

B Virus ◽

Acute Hepatitis A ◽

Hepatitis B Virus Infections

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Viral Superinfection in Previously Unrecognized Chronic Carriers of Hepatitis B Virus with Superimposed Acute Fulminant versus Nonfulminant Hepatitis

Journal of Clinical Microbiology ◽

10.1128/jcm.37.1.235-237.1999 ◽

1999 ◽

Vol 37 (1) ◽

pp. 235-237 ◽

Cited By ~ 9

Author(s):

Chia-Ming Chu ◽

Chau-Ting Yeh ◽

Yun-Fan Liaw

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Acute Hepatitis ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Hepatitis B Surface Antigen ◽

Significant Difference ◽

B Virus ◽

Hdv Infection

The role of viral superinfection in hepatitis B surface antigen carriers with superimposed fulminant (n = 60) versus nonfulminant (n = 90) acute hepatitis was studied. The frequency of hepatitis A virus (HAV) (0 versus 2.2%), HCV (18.3 versus 21.1%), HDV (15.0 versus 7.8%), and HEV (1.7 versus 4.4%) infection showed no significant difference, while simultaneous HCV and HDV infection was significantly more prevalent in the former (8.3 versus 0%). Only 3.6% of fulminant cases and 3.3% of nonfulminant controls were HGV RNA positive.

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Viral Hepatitis in Pregnancy: Problems for the Clinician Dealing with the Infant

Pediatrics in Review ◽

10.1542/pir.2.4.121 ◽

1980 ◽

Vol 2 (4) ◽

pp. 121-125

Author(s):

Cladd E. Stevens ◽

Saul Krugman ◽

Wolf Szmuness ◽

R. Palmer Beasley

Keyword(s):

Hepatitis B ◽

Chronic Active Hepatitis ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Carrier State ◽

Hbv Infection ◽

Advanced Cirrhosis ◽

B Virus ◽

Hepatitis B Antigens ◽

Chronic Carrier

Stokes and colleagues first described transmission of hepatitis B virus (HBV) infection from a mother who was an HBV carrier to an infant born by cesarean section in 1954. Evidence of clinical hepatitis with jaundice, detected at 2 months of age, was later complicated by chronic active hepatitis. The infant died at 18 months of age with advanced cirrhosis of the liver. In the past decade tests have been developed that are specific for hepatitis B antigens and antibodies and they have enabled physicians to identify acute hepatitis B infection during pregnancy, as well as the presence of a chronic carrier state. Thus it has been possible to assess the effect of maternal HBV infection on the newborn infant. The attack rate of HBV infection in infants has been reported to range between 10% and 70%. Infection is usually detectable by 1 to 3 months of age. Although most infections are asymptomatic, fulminant hepatitis is seen on rare occasions. Of major significance is the tendency for the infected infants to become chronic HBV carriers with possible progression to chronic active hepatitis, cirrhosis, and rarely hepatoma. Hepatitis A virus (HAV) infection has not been a problem in the newborn. Hepatitis A is now an uncommon infection among adults in Western countries while in developing areas it is primarily a disease of childhood.

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