Management of Rubella Outbreaks in Hospitals-Reply

Walter A. Orenstein, MD; Kenneth J. Bart, MD; Harrison C. Stetler, MD
JAMA. 1983;249(13):1709. doi:10.1001/jama.1983.03330370023017.
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In Reply.—  Drs Schrock and Rhame suggest a reasonable approach for dealing with a rubella outbreak in institutions that adopt a limited rubella immunization policy. The "rubella-safe" ward could protect potentially susceptible pregnant patients while some or all other staff can be tested and immunized. However, as helpful as the rubella-safe ward might be, it is not an ideal solution for controlling rubella. Rubella transmission could still continue among staff other than those associated with the safe ward. In a recent rubella epidemic in an area of a California hospital where rubella vaccination was voluntary, transmission continued among hospital staff of both sexes for three generations.1 Two of the pregnant personnel elected therapeutic abortions as a result of infection acquired in hospitals.The rubella-safe ward protects only patients after rubella is recognized in the hospital and does not necessarily protect hospital personnel. Staff with inapparent infection could still transmit


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