Prevalence and management of measles susceptibility in healthcare workers in Italy: a systematic review and meta-analysis.

The national and international guidelines recommend evaluating all healthcare workers (HCWs) for their measles immune status and possibly vaccinating those who are seronegative. We conducted a systematic review and meta-analysis in order to estimate the rate of measles susceptibility among HCWs in Italy and to explore possible options for the management of those found to be susceptible. Twenty-three studies were included in the meta-analysis. The prevalence of HCWs susceptible to measles was 11.5% (95%CI = 8.1-15.4%) and was higher in studies in which prevalence was evaluated by survey (16.7%; 95%CI = 8.9-26.3) than by the direct evaluation of blood specimens (9.1%; 95%CI = 6.2-12.5%). Occupational medicine examinations for measles screening with possible subsequent vaccination of seronegatives and the exclusion of susceptible HCWs from high-risk settings were common management strategies. HCWs susceptible to measles are an important epidemiological concern in Italy, and efforts to identify and actively offer the vaccine to this population should be increased.