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Institute
Background: Hundreds of West African healthcare workers (HCW) have become ill with Ebola virus disease (EVD) and died during the recent outbreak. The occurrence of occupational infections in laboratories could be due to the lack of use of personal protective equipment, the failure to implement specific regulations about the use of equipment and how to work with hazardous materials. Our study attempted to assess the information as well as training level of HCW of a German high level isolation unit and their concern over an occupationally acquired EVD.
Methods: During the recent Ebola virus outbreak a survey was conducted among HCWs, using an anonymous questionnaire.
Results: Although 70% of our total study population stated that they have all the information needed to care for Ebola patients, only 18.2% of laboratory workers and 29.4% of the HCW of the virology department felt sufficiently trained. The HCW rated the Internet (64.3%) and the daily press (54.3%) as the most important sources of information. Medical literature (45.7%) and official institutions (40.4%) were rated less often.
Conclusions: Formulated pointedly, the HCW turned to popular science to get the information they need to feel safe. Further in house training regarding practical skills and reference to scientific literature would be a better solution to ensure workplace safety.
Einleitung: Medizinisches Personal ist dem Risiko ausgesetzt, sich an kontaminierten Instrumenten zu verletzen. Nadelstichverletzungen (NSV) können zu ernsthaften und möglicherweise schwerwiegenden Infektionen wie Hepatitis B (HBV), Hepatitis C (HCV) und HIV-Infektionen führen. Dieses Risiko betrifft auch Medizinstudenten im Verlaufe ihrer klinischen Ausbildung. Jede NSV sollte als Arbeitsunfall gemeldet werden, damit postexpositionelle Maßnahmen eingeleitet sowie etwaige Infektionen frühzeitzeitig erkannt und behandelt werden können. Im Falle einer Infektion können versicherungsrechtliche Ansprüche gegenüber den Berufsgenossenschaften geltend gemacht werden. Ziel unserer Studie war die Erhebung der Häufigkeit und Melderate von NSV bei Medizinstudenten.
Methoden: Anonyme Fragebogenerhebung bei Medizinstudenten vor Beginn des Praktischen Jahres.
Ergebnisse: Von den befragten Studenten gaben 58,8% (n=183/311) mindestens eine NSV im Rahmen des Studiums an. Insgesamt 284 NSV wurden von den befragten Studenten gemeldet. Lediglich 38,3% der Studenten hatten alle NSV gemeldet. Die häufigste Ursache für das Nichtmelden der NSV war Schamgefühl aufgrund der Verletzung (54,0%).
Schlussfolgerungen: Expositionen gegenüber Blut sind eine häufige und ernstzunehmende Gefährdung von Medizinstudenten. Es sollten Maßnahmen ergriffen werden, um die Häufigkeit von NSV zu reduzieren und das Meldeverhalten der Studenten zu optimieren. Entsprechende Schulungen sollten sowohl die technischen Fertigkeiten der Studenten als auch das Bewusstsein über die Gefährdung durch NSV vermitteln.
Introduction: Healthcare workers (HCWs) are exposed to bloodborne pathogens (e.g., contaminated devices). In the healthcare environment, needlestick injuries (NSI) represent a major risk factor in the transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Medical students are at risk of occupational exposure to bloodborne viruses following needlestick injuries during medical education. Reporting of needlestick injuries is an important step for initiating early prophylaxis or treatment. In the case of a bloodborne infection, pursuant to insure law could result in a claim. The objective of the present study was to describe occupational blood exposure of medical students through needlestick injuries.
Methods: Sixth-year medical students were invited to complete an anonymous questionnaire.
Results: In our study, 58.8% (n=183/311) of medical students recalled at least one needlestick injury during their studies. Overall, 284 needlestick injuries were reported. Only 38.3% of medical students reported all NSI to the appropriate hospital personnel. The main reason (54.0%) for not reporting NSI was being ashamed of having an NSI.
Conclusions: Occupational exposure to blood is a common problem among medical students. Efforts are required to ensure greater awareness among medical students about the risk of bloodborne pathogens. Proper training in procedures and how to act in case of injury should be offered to reduce the number of needlestick injuries.
Medical students are exposed to infectious diseases during the course of their clinical training. Unfortunately, vaccination rates among medical students remain insufficient. However, immunizations against vaccine-preventable diseases should be carried out before the students enter clinical courses. This is vital in order to prevent nosocomial infections. We screened 366 medical students in their first clinical year for hospital-related viral diseases. Serum samples were collected between April and May 2007. Antibody testing was carried out using commercial ELISA systems against measles, mumps, rubella, varicella, hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Overall, 63.9% (n=234) of the students were sufficiently vaccinated against HBV. In contrast, 31.7% (n=116) had not received any HBV vaccine dosage, and 4.4% (n=16) had not completed the full vaccine cycle (<3 dosage). Remarkably, two students showed serological markers of resolved HBV infection. In addition, one student was HCV-positive and one was HIV-positive, respectively. The following seronegative rates were found: measles (7.9%), mumps (17.5%), rubella (6.5%), and varicella (2.2%). Further work is needed to identify optimal strategies for improving vaccination rates among medical students. It is imperative to identify and limit possible disparities in immunity of vaccine-preventable diseases before initial patient contact. With regard to the primary diagnosis of serious virus diseases including HBV, HCV and HIV, medical students should be screened for these blood borne pathogens.
Medizinstudenten sind im Rahmen ihrer klinischen Ausbildung einer erhöhten Infektionsgefährdung ausgesetzt. Dessen ungeachtet sind die Impfraten der Medizinstudenten ungenügend. Ein adäquater Impfstatus der Medizinstudenten vor Beginn ihres klinischen Ausbildungsabschnitts ist jedoch wichtig, um nosokomiale Infektionen zu vermeiden.
Im April und Mai 2007 wurden insgesamt 366 Serumproben von Medizinstudenten des ersten klinischen Semesters ausgewertet. Die serologischen Untersuchungen erfolgten mittels etablierter ELISA-Systeme. Untersucht wurde auf spezifische Antikörper gegen Masern, Mumps, Röteln, Varizellen, Hepatitis B (HBV), Hepatitis C (HCV) und HIV.
Insgesamt 63,9% (n=234) der Studenten waren gegen Hepatitis B geimpft (Grundimmunisierung, drei Impfdosen). Dagegen hatten 31,7% (n=116) der Studenten bisher noch keine Hepatitis B-Impfung und 4,4% (n=16) kein komplettes Impfschema erhalten (<drei Impfungen). Zwei Studenten zeigten serologische Marker einer abgelaufenen HBV-Infektion. Es wurde die Erstdiagnose einer HCV-Infektion sowie die Erstdiagnose einer HIV-Infektion gestellt. Bei 7,9% (Masern), 17,5% (Mumps), 6,5% (Röteln) und 2,2% (Varizellen) der Studenten konnten keine virusspezifischen Antikörper nachgewiesen werden.
Es sollten weitere Anstrengungen unternommen werden, um die Impfraten der Medizinstudenten zu verbessern. Es ist wichtig, Immunitätslücken zu identifizieren und vor dem ersten Patientenkontakt zu schließen. Im Hinblick auf die Erstdiagnose und die Folgen schwerwiegender blutübertragbarer Erkrankungen (z.B. HBV, HCV und HIV) sollten Medizinstudenten auf diese Infektionen untersucht werden.
Background: Influenza vaccination of healthcare workers (HCWs) is recommended to prevent the transmission of influenza to vulnerable patients. Nevertheless, vaccination coverage rates of HCWs in European countries have been low.
Aim: To investigate the relative and combined strength of sociocognitive variables, from past research, theory and a qualitative study, in explaining the motivation of HCWs to receive the influenza vaccine.
Methods: An anonymous, online questionnaire was distributed among HCWs in hospital settings in Belgium, Germany and the Netherlands between February and April 2013.
Findings: Attitude and past vaccination uptake explained a considerable amount of variance in the intention of HCWs to receive the influenza vaccine. Moreover, low perceived social norms, omission bias, low moral norms, being older, having no patient contact, and being Belgian or Dutch (compared with German) increased the probability of having no intention to receive the influenza vaccine compared with being undecided about vaccination. High intention to receive the influenza vaccine was shown to be more likely than being undecided about vaccination when HCWs had high perceived susceptibility of contracting influenza, low naturalistic views, and lower motivation to receive the vaccine solely for self-protection.
Conclusion: Country-specific interventions and a focus on different sociocognitive variables depending on the intention/lack of intention of HCWs to receive the influenza vaccine may be beneficial to promote vaccination uptake.
Purpose: Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) replicates predominantly in the upper respiratory tract and is primarily transmitted by droplets and aerosols. Taking the medical history for typical COVID-19 symptoms and PCR-based SARS-CoV-2 testing have become established as screening procedures. The aim of this work was to describe the clinical appearance of SARS-CoV-2-PCR positive patients and to determine the SARS-CoV-2 contact risk for health care workers (HCW).
Methods: The retrospective study included n = 2283 SARS-CoV-2 PCR tests from n = 1725 patients with otorhinolaryngological (ORL) diseases performed from March to November 2020 prior to inpatient treatment. In addition, demographic data and medical history were assessed.
Results: n = 13 PCR tests (0.6%) were positive for SARS-CoV-2 RNA. The positive rate showed a significant increase during the observation period (p < 0.01). None of the patients had clinical symptoms that led to a suspected diagnosis of COVID-19 before PCR testing. The patients were either asymptomatic (n = 4) or had symptoms that were interpreted as symptoms typical of the ORL disease or secondary diagnoses (n = 9).
Conclusion: The identification of SARS-CoV-2-positive patients is a considerable challenge in clinical practice. Our findings illustrate that taking a medical history alone is of limited value and cannot replace molecular SARS-CoV-2 testing, especially for patients with ORL diseases. Our data also demonstrate that there is a high probability of contact with SARS-CoV-2-positive patients in everyday clinical practice, so that the use of personal protective equipment, even in apparently “routine cases”, is highly recommended.
Objectives: Regarding reactogenicity and immunogenicity, heterologous COVID-19 vaccination regimens are considered as an alternative to conventional immunization schemes.
Methods: Individuals receiving either heterologous (ChAdOx1-S [AstraZeneca, Cambridge, UK]/BNT162b2 [Pfizer-BioNTech, Mainz, Germany]; n = 306) or homologous (messenger RNA [mRNA]-1273 [Moderna, Cambridge, Massachusetts, USA]; n = 139) vaccination were asked to participate when receiving their second dose. Reactogenicity was assessed after 1 month, immunogenicity after 1, 3, and/or 6 months, including a third dose, through SARS-CoV-2 antispike immunoglobulin G, surrogate virus neutralization test, and a plaque reduction neutralization test against the Delta (B.1.167.2) and Omicron (B.1.1.529; BA.1) variants of concern.
Results: The overall reactogenicity was lower after heterologous vaccination. In both cohorts, SARS-CoV-2 antispike immunoglobulin G concentrations waned over time with the heterologous vaccination demonstrating higher neutralizing activity than homologous mRNA vaccination after 3 months to low neutralizing levels in the Delta plaque reduction neutralization test after 6 months. At this point, 3.2% of the heterologous and 11.4% of the homologous cohort yielded low neutralizing activity against Omicron. After a third dose of an mRNA vaccine, ≥99% of vaccinees demonstrated positive neutralizing activity against Delta. Depending on the vaccination scheme and against Omicron, 60% to 87.5% of vaccinees demonstrated positive neutralizing activity.
Conclusion: ChAdOx1-S/BNT162b2 vaccination demonstrated an acceptable reactogenicity and immunogenicity profile. A third dose of an mRNA vaccine is necessary to maintain neutralizing activity against SARS-CoV-2. However, variants of concern-adapted versions of the vaccines would be desirable.
Nosocomial infectious diseases (e.g. influenza, pertussis) are a threat particularly for immunocompromised and vulnerable patients. Although vaccination of healthcare workers (HCWs) constitutes the most convenient and effective means to prevent nosocomial transmissions, vaccine uptake among HCWs remains unacceptably low. Worldwide, numerous studies have demonstrated that nurses have lower vaccination rates than physicians and that there is a relationship between receipt of vaccination by HCWs and knowledge. Measures to improve vaccination rates need to be profession-sensitive as well as specific in their approach in order to achieve sustained success.
Health-care personnel (HCP) are exposed to infectious diseases throughout the course of their work. The concerns of pregnant HCP are considerable because certain otherwise mild infections may affect fetal development. We studied 424 pregnant HCP at the University Hospital Frankfurt / Germany between March 2007 and July 2011. Serological tests were carried out for varicella zoster virus (VZV), measles, mumps, rubella (MMR), cytomegalovirus (CMV) and parvovirus B19. Our overall seroprevalence data with regard to VZV, MMR, CMV and parvovirus B 19 corresponded to the general population. It was striking that, only 57.1% of the study population was immune against the four vaccine-preventable diseases (MMR, VZV). Our study suggests that a comprehensive approach to improving the vaccination status of said HCP before pregnancy is paramount.