Hand-foot-and-mouth disease can cause significant nosocomial outbreaks among hospital personnel with substantial economic impact, even without transmission to patients.
HFMD outbreaks among staff may drive hospital costs without patient transmission; this Level 5 report leaves open generalizability and prevention needs.
In the fall of 1983 an outbreak of hand-foot-and-mouth disease occurred in a large urban hospital. The outbreak began among surgical nurses confined to one area of the operating suite and appeared to spread by direct contact to personnel working in the other areas. No cases were diagnosed among hospital patients. There was no evidence to support an ongoing community epidemic as only three of 98 physicians surveyed had seen hand-foot-and-mouth disease in their practices, and none occurred among family members of 94 unaffected employees. The outbreak resulted in 82 lost workdays at an estimated cost to the hospital of $5,676. Existing infection control guidelines do not address the issue of transmission of hand-foot-and-mouth disease from hospital personnel to patients; our experience suggests that the risk of transmission, at least in the operating suite environment, may be greater for other personnel than for patients.
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Johnston et al. (1986) studied this question.
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