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Postexposure Interventions to Prevent Infection With HBV, HCV, or HIV, and Tetanus in People Wounded During Bombings and Other Mass Casualty Events—United States, 2008: Recommendations of the Centers for Disease Control and Prevention and Disaster Medicine and Public Health Preparedness

Published online by Cambridge University Press:  08 April 2013

Abstract

People wounded during bombings or other events resulting in mass casualties or in conjunction with the resulting emergency response may be exposed to blood, body fluids, or tissue from other injured people and thus be at risk for bloodborne infections such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or tetanus. This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass casualty event. Decisions regarding the implementation of prophylaxis are complex, and drawing parallels from existing guidelines is difficult. For any prophylactic intervention to be implemented effectively, guidance must be simple, straightforward, and logistically undemanding. Critical review during development of this guidance was provided by representatives of the National Association of County and City Health Officials, the Council of State and Territorial Epidemiologists, and representatives of the acute injury care, trauma, and emergency response medical communities participating in the Centers for Disease Control and Prevention’s Terrorism Injuries: Information, Dissemination and Exchange project. The recommendations contained in this report represent the consensus of US federal public health officials and reflect the experience and input of public health officials at all levels of government and the acute injury response community. (Disaster Med Public Health Preparedness. 2008;2:150–165)

Type
Original Research and Critical Analysis
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2008

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References

REFERENCES

1. Federal Bureau of Investigation. Terrorism 2002–2005. 2006. http://www.fbi.gov/publications.htm.Google Scholar
2.Siegel-Itzkovich, J.Israeli minister orders hepatitis B vaccine for survivors of suicide bomb attacks. BMJ. 2001;323:417.CrossRefGoogle ScholarPubMed
3.Braverman, I, Wexler, D, Oren, M.A novel mode of infection with hepatitis B: penetrating bone fragments due to the explosion of a suicide bomber. Isr Med Assoc J. 2002;4:528529.Google Scholar
4.Wong, JM, Marsh, D, Abu-Sitta, G, et alBiological foreign body implantation in victims of the London July 7th suicide bombings. J Trauma. 2006;60:402404.CrossRefGoogle ScholarPubMed
5.Hepatitis B Vaccination Protocol in Survivors of Mass Casualty Bombings. Israel Ministry of Health Medical Guidelines 2001 (35)/1/13 (Communique 57/2001). Tel Aviv: Israel Ministry of Health; 2001.Google Scholar
6.Hepatitis B Vaccination Protocol in Survivors of Mass Casualty Bombings–revision. Israel Ministry of Health Medical Guidelines 2001 (35)/2/13 (Communique 72/2001). Tel Aviv: Israel Ministry of Health; 2001.Google Scholar
7.Post-exposure Prophylaxis Against Hepatitis B for Bomb Victims and Immediate Care Providers. Consideration of Other Blood borne Viruses (Hepatitis C and HIV). London: Health Protection Agency; 2005.Google Scholar
8.Jagger, J, De Carli, G, Perry, J, Puro, V, Ippolito, G. Occupational exposure to bloodborne pathogens: epidemiology and prevention.Wenzel R Prevention and Control of Nosocomial Infections. 4th ed. Baltimore: Lippincott Williams & Wilkins; 2003.Google Scholar
9.Alter, HJ, Stramer, SL, Dodd, RY.Emerging infectious diseases that threaten the blood supply: I. Semin Hematol. 2007;44:3241.CrossRefGoogle Scholar
10.Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2006;55 (No. RR-7).Google Scholar
11.A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP): II. Immunization of adults. MMWR. 2006;55 (No. RR-16).Google Scholar
12.Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR. 2001;50 (No. RR-11).Google Scholar
13.National, state, and local area vaccination coverage among children aged 19–35 months—United States, 2006. MMWR. 2007;56:880885.Google Scholar
14.National vaccination coverage among adolescents aged 13–17 years—United States, 2006. MMWR. 2007;56:885888.Google Scholar
15.Hepatitis B vaccination among adults—United States, 2004. MMWR. 2006;55:509511.Google Scholar
16.Armstrong, GL, Wasley, A, Simard, EP, McQuillan, GM, Kuhnert, WL, Alter, MJ.The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. 2006;144:705714.CrossRefGoogle ScholarPubMed
17.Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR. 1998;47 (No. RR-19).Google Scholar
18.Beltrami, EM, Kozak, A, Williams, IT, et alTransmission of HIV and hepatitis C virus from a nursing home patient to a health care worker. Am J Infect Control. 2003;31:168175.CrossRefGoogle ScholarPubMed
19.Kamili, S, Krawczynski, K, McCaustland, K, Li, X, Alter, MJ.Infectivity of hepatitis C virus in plasma after drying and storing at room temperature. Infect Control Hosp Epidemiol. 2007;28:519524.CrossRefGoogle ScholarPubMed
20.Patel, PR, Larson, AK, Castel, AD, et alHepatitis C virus infections from a contaminated radiopharmaceutical used in myocardial perfusion studies. JAMA. 2006;296:20052011.Google Scholar
21.HIV/AIDS Surveillance Report, Cases of HIV Infection and AIDS in the United States and Dependent Areas, 2005. Vol 17. Revised June 2007. Atlanta: US Department of Health and Human Services, Public Health Service, CDC; 2007.Google Scholar
22.Updated U.S. Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis. MMWR. 2005;54 (No. RR-9).Google Scholar
23.Notice to readers: updated information regarding antiretroviral agents used as HIV postexposure prophylaxis for occupational HIV exposures. MMWR. 2007;56:12911292.Google Scholar
24.Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States. MMWR. 2005;54 (No. RR-2).Google Scholar
25.Bell, DM.Occupational risk of human immunodeficiency virus infection in health-care workers: an overview. Am J Med. 1997;102:915.CrossRefGoogle Scholar
26.Preventing tetanus, diphtheria and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP) and Recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel. MMWR. 2006;55 (No. RR-17).Google Scholar
27.Pascual, FB, McGinley, E, Zanardi, L, et alTetanus surveillance—United States, 1998–2000. CDC Surveillance Summaries, June 20, 2003. MMWR. 2003;52 (No. SS-3).Google Scholar
28. Srivastava P, Brown K, Chen J, Kretsinger K, Roper M. Trends in tetanus epidemiology in the United States, 1972–2001. Paper presented at 39th National Immunization Conference, Washington, DC; March 21–24, 2005. http://cdc.confex.com/cdc/nic2005/techprogram/paper_7813.htm. Accessed August 8, 2008.Google Scholar
29.McQuillan, GM, Kruszon-Moran, D, Deforest, A, et alSerologic immunity to diphtheria and tetanus in the United States. Ann Intern Med. 2002;136:660666.CrossRefGoogle ScholarPubMed
30.Fair, E, Murphy, T, Golaz, A, Wharton, M.Philosophic objection to vaccination as a risk factor for tetanus among children younger than 15 years. Pediatrics. 2002;109:E2.CrossRefGoogle Scholar
31.Talan, DA, Abrahamian, FM, Moran, GJ, et alTetanus immunity and physician compliance with tetanus prophylaxis practices among emergency department patients presenting with wounds. Ann Emerg Med. 2004;43:305311.Google Scholar
32.Preventing tetanus, diphtheria, and pertussis among adolescents: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2006;55 (No. RR-3).Google Scholar
33.Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1991;40 (No. RR-10).Google Scholar
34. Childhood, adolescent and adult immunization schedules. US Department of Health and Human Services, CDC Web site. 2007. http://www.cdc.gov/vaccines/recs/schedules/default.htm. Accessed August 8, 2008.Google Scholar
35.Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR. 2006;55 (No. RR-14).Google Scholar
36. Interim immunization recommendations for disaster responders. US Department of Health and Human Services, CDC Web site. 2005. http://www.bt.cdc.gov/disasters/disease/responderimmun.asp. Accessed August 8, 2008.Google Scholar
37. Emergency wound care after a natural disaster. US Department of Health and Human Services, CDC Web site. 2005. http://www.bt.cdc.gov/disasters/woundcare.asp. Accessed August 8, 2008.Google Scholar
38. Update: NIOSH warns of hazards of flood cleanup work. NIOSH publication no. 94-123. US Department of Health and Human Services, CDC Web site. 1997. http://www.cdc.gov/niosh/flood.html. Accessed August 8, 2008.Google Scholar
39. Fact sheets on natural disaster recovery: flood cleanup. US Department of Labor, Occupational Safety and Health Administration Web site. 2008. http://www.osha.gov/OshDoc/floodCleanup.html. Accessed August 8, 2008.Google Scholar
40.General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2006;55 (No. RR-15).Google Scholar
41.Prevention of pertussis, tetanus, and diphtheria among pregnant and postpartum women and their infants: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2008;57 (No. RR-4).Google Scholar
42. Bloodborne Pathogens Standard, 29 C.F.R. Sect. 1910.1030 [56 FR 64004, Dec. 06, 1991, as amended at 57 FR 12717, April 13, 1992; 57 FR 29206, July 1, 1992; 61 FR 5507, Feb. 13, 1996; 66 FR 5325 Jan., 18, 2001; 71 FR 16672 and 16673, April 3, 2006].Google Scholar