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Chickenpox • Chickenpox, also known as varicella, is a highly infectious disease caused by the varicella zoster virus. The first sign of illness is usually a rash that looks like small blisters and is very itchy. The blisters can be found all over the body, on the face and scalp. The virus is spread easily through the air by infected people when they cough or sneeze. The disease also spreads through contact with an infected person's chickenpox blisters, either by direct contact with a person’s blisters or clothing that has touched the blisters or though the air. When somebody has had chickenpox, the virus often stays in the nerve cells near the spinal cord and may be reactivated at any time in that person’s life causing shingles. It is not always know what causes it to reactivate but it may be due to conditions that affect immunity such as immunosuppressive diseases or old age. • Q1 Why should I have the chickenpox vaccine? • Chickenpox vaccine is recommended for unprotected healthcare workers who have direct contact with patients and who work in general practice or in hospitals. This is because • if you have not previously had chickenpox, you are at risk of catching the infection from patients and • it will prevent you passing on chickenpox infection to vulnerable patients if you do become infected.
Tuberculosis • TB most commonly affects the lungs but can affect almost any part of the body. It can be spread when someone with the infection coughs, sneezes or talks and another person breathes in the bacteria. However, prolonged contact is usually needed to become infected. • Tuberculosis immunity is confirmed by the presence of a BCG scar or a positive heaf test (grade 2) or mantoux test (6-15mm duration). The BCG scar must be identified and confirmed by a trained medical professional certified to do such checks.
Measles, Mumps & Rubella • Rubella is caused by a virus that's spread by droplets inhaled into the respiratory tract. It only causes a mild illness in children, but if a woman contracts rubella during pregnancy it can endanger her unborn child. • Measles is caused by a virus that is spread by droplets. The virus is passed on through direct contact with someone who is infected, for example by touching or kissing them, or through breathing in contaminated air. It is fairly easy to catch if you have not been vaccinated and come into contact with someone who has the infection, which is why epidemics often occur among schoolchildren. • Mumps is a viral infection of the parotid glands. These glands, which normally make saliva, are found either side of the face below the ears and over the jaw bone. The illness used to be common but is rarer now that immunisation with the MMR vaccine is routine. Mumps is spread in saliva or in the tiny droplets of fluid when someone coughs or sneezes. People with mumps are infectious from up to seven days before and up to ten days after the glands first start to swell. • Proof of immunity of measles, mumps and rubella is required for all healthcare workers. The proof required is either evidence of two MMR vaccinations ora serology report showing the presence of antibodies to measles, mumps and rubella. If any of the viruses are reported as negative two MMR vaccinations are required to address this.
Hepatitis B • Hepatitis B is one of the most common infectious diseases in the world. Hepatitis B, a virus that infects the liver, is passed from one person to the other by blood and body fluids. Hepatitis B infections are either acute or chronic. Acute Hepatitis B can last from a few weeks to a few months and the sufferer may recover without intervention. Chronic Hepatitis B is a disease that may remain for life and can lead to serious liver diseases, including liver cancer or cirrhosis. • Vaccination against Hepatitis B consists of three injections followed by a blood test to determine the level of immunity. The desired level is greater than 100iu/ml. A booster and a blood test is required after 5 years to ensure full immunity.
Identity Validated Sample (IVS) Data regarding hepatitis B, C and HIV status must come from an identified validated sample. This is needed because of a previous case where another person’s blood was used by a worker doing exposure prone procedures in order to achieve clearance. Identified Validated Sample protocol: • The healthcare worker should give proof of identity – with a photograph, Trust identity badge or passport etc. • Samples should be delivered to the laboratory in the usual manner not taken there by the healthcare worker. You can utilise services such as TDL: http://www.tdlpathology.com • When results are received from the laboratory, check that your department has, in fact, sent the blood and then record the result in the relevant notes and on the report.
Serology reports format • We must be able to identify where all reports come from and who is reporting the results. • Reports should be on letter headed paper or official laboratory serology reports. If faxed or emailed copies are submitted these should be stamped by the issuer to validate the report.
Questions? • If you have any questions regarding the immunisation requirements please contact us on 0208 870 8143 and we will be more than happy to clarify any queries you may have.
