Can we protect our patients and employees from childhood diseases?

Nosocomial infections acquired by hospital personnel pose a special problem for the infection control practitioner. Even in an institution with an established employee health program and clearly designed procedures, an outbreak of measles or varicella causes time-consuming and expensive investigations. Chou et al were prompted by a measles outbreak in their community to review the available data on susceptibility of young adults to the measles virus. In their well-designed study, they investigated the measles susceptibility of 266 health care workers, especially physicians and nurses, in a metropolitan hospital; they found only one serosusceptible person. The very high prevalence of measles antibodies is surprising and can probably be attributed to the number and sensitivity of the laboratory test methods used, especially the enzyme-immunoassay and the plaque neutralization test. In another contribution in this issue, Krasinski et al present their experience with nosocomial varicella-zoster virus infections and the problems of effective infection control including serologic testing. Our institution recently experienced a similar infection control exercise and, like our colleagues in New York, we spent much time and money to assess the immune status of our co-workers at highest risk.