In early 1982, 15 hospitals in Los Angeles County reported one or more serologically confirmed rubella cases among their employees. Secondary cases occurred at eight hospitals; overall, 56 cases were identified among employees, of which 28 were serologically confirmed. Testing of 2,061 employees revealed 1,770 (86%) with detectable antibody. A survey of 83 hospitals offering obstetrical services indicated only 42% (33 of 78) had an established rubella screening policy. Based on the results of this survey, the Los Angeles County Department of Health Services published recommendations for hospital rubella screening and immunization policies.

To evaluate the risk to nurses of childbearing age of acquiring cytomegalovirus (CMV) infection during the care of patients at high risk of the infection, 374 female hospital employees (288 nursing personnel) were interviewed and screened for antibody to CMV. Fifty-six percent of the population surveyed had antibody to CMV as measured by an immunofluorescent assay. Among nursing personnel, analysis of antibody prevalence by job title, work area, and duration of work showed no association between seropositivity and either current or past exposure to “high-risk” patients, such as infants and immunosuppressed individuals. Age, race (non-white), and the number of pregnancies reported by participants were significantly associated with the presence of antibody. Among 73 employees of a children's hospital, the prevalence of CMV antibody was 41%. This survey suggests that hospital nursing is not a major risk factor for acquiring CMV infection. However, this finding needs further evaluation in a prospective study of seroconversion rates among seronegative nurses.

Contaminated multiple-dose medication vials (MDV) have been implicated in transmission of bacterial infections. It has been suggested that MDV be discarded after 24 hours or even after a single use. At our hospital, we cultured 1,223 weekly samples from 864 MDV in-use over a three-month period. Medications included xylocaine, insulin, heparin, immunizations, and miscellaneous agents. None of the samples was culture-positive. The duration of use was 9.5d (median), 18d (mean), and 1-402d (range) with 13% of vials in-use for more than 30 days. The mean duration of use was significantly shorter for medicine wards, emergency room, and outpatient clinics than for surgery and obgyn wards (p<0.05). Heparin and insulin MDV were in-use for significantly less time than xylocaine and miscellaneous agents (p<0.05), and insulin MDV were more regularly dated (p=0.001). The percentage of undated MDV declined significantly by month during die study (p=0.003). These results lend support to our current guideline that MDV should be dated upon opening and that, unless visible or suspected contamination occurs, vials are discarded either when empty or at the manufacturer's expiration date.

An outbreak of group A β-hemolytic streptococcal infections involving three parturients, three newborns, and a nursery RN is reported. Six of six organisms available for serotyping were M-untypable, T-11, serum opacity reaction-negative. Propagation of the outbreak may have been fostered by the common use of a single sitz bath, although the evidence to support this is weak. The outbreak was rapidly controlled via strict cohorting, appropriate treatment and isolation of cases, and the routine use of triple dye for umbilical cord care.

The bacteriologic content of expressed breast milk was studied in 30 mothers at the time of expression and after 24 and 48 hours of refrigeration. There were no significant differences in colony counts between the three time intervals. All samples contained Staphylococcus epidermidis. In addition, eight other species were found, including four which were gram-negative. All samples contained <106 colonies/ml, and there were no significant differences in mean colony counts between samples expressed at home and at the hospital. We conclude that it is bacteriologically safe to refrigerate expressed breast milk for up to 48 hours.