A close shave? Performance of P2/N95 respirators in healthcare workers with facial hair: results of the BEARDS (BEnchmarking Adequate Respiratory DefenceS) study.

P2/N95 filtering face piece respirators (FFRs) protect healthcare workers (HCWs) from airborne infections. This study assessed the impact of facial hair on quantitative respirator fit in 105 male HCWs, of whom 38 were clean shaven, and assessed the prevalence of male facial hair at the study facility. Only 34 (32%) male HCWs overall achieved an adequate FFR fit, including 47% of clean-shaven men. No full-bearded HCWs achieved a fit. Adequate respirator fit decreased significantly with increasing facial hair (P<0.01 for trend). Facial hair was present on 49% of male employees. This study supports quantitative fit testing prior to P2/N95 respirator use.

Hepatitis A in south-eastern Sydney 1997-1999: continuing concerns for gay men and an outbreak among illicit drug users.

The incidence of hepatitis A virus (HAV) in south-eastern Sydney is one of the highest in Australia with large outbreaks previously associated with male-to-male sexual contact. We report HAV notification trends over the period 1 June 1997 to 31 May 1999 for this location. In the first twelve-month period, 233 cases were notified (crude rate 30.5/100,000 per year) with a peak incidence of 110/100,000 in males aged 20-39 years. Over 60% of male cases reported male-to-male sexual contact. The notification rate (crude rate 15.5/100,000) and proportion of males (61%) was considerably lower in the following twelve month period with 118 cases notified. Less than a third of males reported male-to-male sexual contact. An outbreak (n = 45) of HAV among illicit drug users and their contacts was detected in December 1998. The transmission of HAV remains endemic in south-eastern Sydney. Vaccination among high-risk groups remains an important preventive strategy.

Unusual cluster of mild invasive serogroup C meningococcal infection in a university college.

The objective of this study was to describe the epidemiology and public health response to an apparent cluster of Neisseria meningitidis serogroup C infection in university students in a residential college. A conventional epidemiological approach was taken, supported by routine and novel diagnostic techniques. Over the two days of 21-22 August 1997, three cases of suspected meningococcal infection were notified from a residential college complex at a university campus in the Sydney metropolitan area. Neisseria meningitidis was grown from throat swabs of all three cases, and was isolated from the blood of one case only. All three isolates were typed as C:2a:P1.5,2. Seroconversion was demonstrated by a novel method in the three cases. Rifampicin was given to all identified contacts. Forty-seven days after the index case, a 19 year old female living in the same complex was diagnosed with bacterial meningitis, and identified contacts given rifampicin. When this isolate was found to be group C, it was decided to vaccinate residents of the college complex. Genotyping and serotyping (C:2a:P1.5) later revealed the fourth isolate to be distinct from isolates from Cases 1-3. In conclusion the authors note that Australia's increasing capacity to type meningococcal strains is essential to understanding the epidemiology of this disease. Furthermore, typing information is of critical importance when decisions are made regarding mass vaccination. As early antibiotic treatment may inhibit isolation of the organism, development of novel approaches to diagnosis and typing should be supported.