American Journal of Infection Control
April 2016 Volume 44, Issue 4, p373-494, e37-e58
http://www.ajicjournal.org/current

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Major Articles
Influenza immunization among resident physicians in an urban teaching hospital
Mubdiul Ali Imtiaz, Lawrence D. Budnick, Andrew R. Berman
p491–493
Published online: December 18 2015
Highlights
:: The self-reported immunization rate of resident physicians in 2013-2014 was 76.7%.
:: Lack of time to get immunized was the most cited reason for nonvaccination.
:: Availability of vaccination at convenient locations and times improves vaccination.
:: Instituting a mandatory influenza vaccine policy was felt to be a strong motivator.
We surveyed resident physicians (RPs) at an academic medical center to determine the rate of influenza vaccination and reasons for nonvaccination. The overall self-reported immunization rate of RPs in 2013-2014 was 76.7%, and the most common reason for not being vaccinated was lack of time to get immunized (38.6%). Making flu vaccination available in training hospitals and at convenient locations and times that take into account varying work schedules may increase compliance.

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Major Articles
Risk factors for measles in children younger than age 8 months: A case-control study during an outbreak in Guangxi, China, 2013
Zhen-Zhu Tang, Yi-Hong Xie, Chuleeporn Jiraphongsa, Xuan-Hua Liu, Zhong-You Li, Virasakdi Chongsuvivatwong
e51–e58
Published online: December 28 2015
Highlights
:: This measles outbreak occurred at a near-elimination point.
:: A quarter of cases were under the recommended vaccination age (8 months).
:: Coverage of two-dose measles-containing vaccine was low (34%).
::The disease possible transmission to children visiting the hospitals.
:: The need for SIAs and prevention of hospital transmission cannot be overemphasized.
Background
Following a period (2009-2012) during which zero measles cases were reported, a measles outbreak occurred in 2013 in Bama County, Guangxi, China, that involved more than 100 children younger than age 8 months. We aimed to identify the pitfalls and risk factors while implementing the control measures.
Methods
An outbreak investigation and a case-control study was conducted among children younger than age 8 months. The serum specimens of the study subjects and their mothers were tested for measles immunoglobulin M and immunoglobulin G.
Results
The attack rate was 2.3/1,000 population. The median (interquartile range) age was 18.6 months (7.9-52.8 months). The coverage of 2-dose measles-containing vaccine was only 34%. The case-control study revealed 2 independent risk factors: low education level of main caregiver (odds ratio [OR], 2.86; 95% confidence interval [CI], 1.31-6.22) and visiting a hospital 7-21 days before the date of symptoms onset (OR, 9.84; 95% CI, 4.27-22.67). The population attributable fraction of the latter was 52.8%. The mothers of the cases had nonsignificantly higher levels of immunoglobulin M and were significantly more likely to have protective levels of immunoglobulin G than those of the controls. This suggests a reactive rather than protective role of the antibody to the child’s infection.
Conclusions
In a near-elimination but low measles-containing vaccine coverage community, supplementary immunization activities should be emphasized for children and women who are potential future mothers. The minimum age of measles-containing vaccine should be further reduced. Hospital measles transmission must also be strictly prevented.