An outbreak of rubella among hospital personnel and measures taken against hospital infection--cost-benefits of the measure

摘要

There is no nationwide outbreak of rubella after 1992 in Japan, but a local outbreak remains. Recently, some cases of congenital rubella syndrome (CRS) were reported after a local outbreak. An outbreak of rubella among hospital personnel occurred in our hospital located on Tanegashima Island on March and April 2003 after a visit of one rubella patient. Fifteen employees, including 7 clerks, 6 nurses, one doctor, and one radiologist, experienced rubella. A total of 259 employees in our hospital employees were examined for anti rubella hemagglutination inhibition (HI) tests with informed consent and recommended to take rubella vaccines. Sixty-seven employees (26%) among 257 examined for tests were found susceptible to rubella, and 53 employees were vaccinated. After vaccination, the outbreak was stamped out immediately. There was no rubella patient infected from employee. Nine among the 15 infected employees had declared to have a history of rubella or rubella vaccines before onsets, suggesting interviews are not reliable. There were many susceptible persons and rubella patients among elderly women and male personnel; therefore, measures are needed for elderly personnel as well as younger employees. In addition, adequate measures should be taken to prevent CRS, because many female personnel capable of pregnancy work in hospitals. The cost of the rubella HI tests and vaccination was approximately yen 200,000 (about dollar 1,600). The absence due to illness per one person was 6 days, and the wage per one day was about yen 12,000 (about dollar 100) on the average. The overall cost required in the outbreak was estimated to be approximate yen 1,400,000 (about dollar 12,000). Considering that an outbreak of rubella causes not only a large amount of expenditure but also loss of hospital income, the investment to prevent a rubella outbreak is quite valuable in the management of a hospital.