In Reply.—Drs Myers and Hierholzer have taken a more conservative stance than we did, both in regard to serologic screening of hospital employees and the incubation period of varicella. We have no theoretical objections to their suggestions.
From a practical point of view, however, the majority of hospitals in the United States do not have ready access to either the FAMA test or ELISA. When exposure occurs, these hospitals must rely on histories of disease for infection-control decisions. Faced with personnel shortages, some hospitals may find it difficult to relieve exposed susceptible employees from patientcare duties for even short periods.
We agree that hospital employees who have direct contact with pediatric or oncologic patients are excellent candidates for future varicella vaccination. This potential should encourage commercial development and distribution of appropriate serologic tests.