Asunto(s)
Obstetricia/historia , Infección Puerperal/historia , Infección Hospitalaria/historia , Infección Hospitalaria/prevención & control , Infección Hospitalaria/transmisión , Femenino , Desinfección de las Manos , Historia del Siglo XIX , Humanos , Hungría , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/historia , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Retratos como Asunto , Embarazo , Salud Pública/historia , Infección Puerperal/prevención & controlRESUMEN
BACKGROUND: Even if the contagious nature of tuberculosis was universally accepted during the nineteenth century, its transmission to health care workers (HCWs) was initially denied by the scientific community. Working among TB patients was not considered dangerous for healthy adults, so the potential risks for HCWs were branded as unwarranted "phthisiophobia" (fear of contracting tuberculosis). OBJECTIVES: This study aims at analyzing the problem of tuberculosis transmission among health care workers from an historical perspective, particularly highlighting the contribution made by the Italian Occupational Medicine community. METHODS: Scientific literature and historical sources on different theories regarding tuberculosis transmission were investigated, specially focusing on the period at the turn of the 19th and 20th centuries. RESULTS: At the beginning of the twentieth century, Luigi Devoto (1864-1936), an Italian pioneer in the field of Occupational Medicine, was one of the first scientists to conduct research on the transmission of tuberculosis among nurses. Since the 1920s several studies, conducted mainly on medical and nursing students, confirmed the risk for HCWs. However an international consensus on this issue was only achieved during the 1950s, when the institution of mandatory chest radiographs on admission for all patients significantly decreased the cases of tuberculosis among HCWs. CONCLUSIONS: Devoto was one of the first scholars who postulated the transmission of tuberculosis to HCWs. He also theorized that hospital personnel with active disease could also be a source of contagion to patients. Nowadays, "third party risk" and latent tuberculosis infection pose a new challenge for occupational physicians in hospitals.
Asunto(s)
Actitud Frente a la Salud , Personal de Salud , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/historia , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/historia , Medicina del Trabajo/historia , Trastornos Fóbicos/historia , Tuberculosis/historia , Tuberculosis/transmisión , Vacuna BCG , Trazado de Contacto , Infección Hospitalaria/epidemiología , Infección Hospitalaria/historia , Infección Hospitalaria/transmisión , Cultura , Brotes de Enfermedades/historia , Miedo , Infecciones por VIH/epidemiología , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Historia del Siglo XV , Historia del Siglo XVI , Historia del Siglo XVII , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Historia Antigua , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Italia/epidemiología , Personal de Hospital/psicología , Personal de Hospital/estadística & datos numéricos , Riesgo , Prueba de Tuberculina , Tuberculosis/diagnóstico , Tuberculosis/epidemiología , Tuberculosis/psicología , Vacunación/historiaAsunto(s)
Asepsia/historia , Salas de Parto/historia , Higiene/historia , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/historia , Infección Puerperal/historia , Austria , Femenino , Desinfección de las Manos , Historia del Siglo XIX , Humanos , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Masculino , Obstetricia/historia , Embarazo , Infección Puerperal/prevención & control , Salud de la Mujer/historiaAsunto(s)
Guantes Quirúrgicos/historia , Animales , Guantes Quirúrgicos/efectos adversos , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/historia , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Hipersensibilidad/etiología , Hipersensibilidad/historia , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/historia , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/historia , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & controlAsunto(s)
Brotes de Enfermedades/historia , Enfermedad Iatrogénica , Infección Puerperal/historia , Femenino , Historia del Siglo XIX , Humanos , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/historia , Embarazo , Infección Puerperal/epidemiología , Infección Puerperal/transmisión , Estados Unidos/epidemiologíaRESUMEN
The epidemics of puerperal fever in the 18th and 19th centuries began soon after the creation of Lying-in hospitals in the mid-18th century. The primary purpose of these hospitals was to provide physicians with training in obstetrics in general and in forceps deliveries in particular. The first reports describing epidemics of puerperal fever, its contagiousness and control were made by British physicians in the latter half of the 18th century. Alexander Gordon provided epidemiological evidence of contagion in 1792, and Oliver Wendell Holmes in the USA reviewed these reports in his paper on outbreaks of puerperal fever around Boston in 1843. Ignaz Semmelweis in Vienna, unaware of previous work on this disease, re-discovered the actions required to control the contagion in 1847, but published his paper much later in 1861. A few enlightened doctors struggled to prove that puerperal fever was contagious and could be spread by doctors and midwives. Their peers and colleagues predominantly displayed apathy and ignorance until forced to act by the weight of evidence. However, it was the multitude of parturient women who paid the ultimate price for these iatrogenic epidemics.
Asunto(s)
Brotes de Enfermedades/historia , Enfermedad Iatrogénica , Infección Puerperal/historia , Infección Hospitalaria/epidemiología , Infección Hospitalaria/historia , Femenino , Historia del Siglo XVIII , Historia del Siglo XIX , Humanos , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/historia , Embarazo , Infección Puerperal/epidemiología , Infección Puerperal/transmisiónRESUMEN
The dangers of occupational infection (where the infectious agent was acquired during the provision or receipt of a medical service) have received renewed interest in the era of the human immunodeficiency virus. The dilemmas raised by this phenomenon, however, are far from novel and were the subject of considerable debate in the medical literature at the turn of the century with regard to syphilis. After recognition of the problem, it took time to manage syphilis effectively through technical innovation, personal prophylaxis, education, and regulation. These efforts led to the development of a strategy remarkably similar to that of the "universal precautions" approach applied to human immunodeficiency virus today.