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CDC, AMA issue advice to protect disaster survivors

To help injured disaster survivors that may be at risk for infection from blood-borne viruses or tetanus in the environment, new vaccine recommendations were released in the August issue of the American Medical Association (AMA) Disaster Medicine and Public Health Preparedness journal. The recommendations are co-published with the Centers for Disease Control and Prevention (CDC).
“Diseases and bacteria that cause disability and death, such as hepatitis B and tetanus, can be prevented by vaccines that are safe, effective and widely available,” said James J. James M.D., AMA Disaster Medicine and Public Health Preparedness journal editor-in-chief and AMA director of the Center for Public Health Preparedness and Disaster Response. “These vaccines may be overlooked in the aftermath of mass casualty events, because attention is focused on management of trauma wounds.”
A blood-borne virus may infect exposed wounds, abraded skin, body fluids, or tissue from injured persons. These new recommendations focus on prevention of infection with hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and tetanus following mass casualty events.

The report was developed through consultation among immunization experts, physicians who specialize in trauma and emergency medicine, and public health epidemiologists.

The new mass casualty vaccine recommendations include the following:

  • Hepatitis B virus: HBV vaccine should be given for exposures of open wounds.
  • Hepatitis C virus: When open wounds are exposed to blood, it may be advisable to refer patients to a primary care provider to consider follow-up testing for HCV.
  • HIV: Post-exposure prophylactic treatment for HIV is almost never indicated in mass casualty settings.
  • Tetanus: If vaccination is not current, tetanus vaccine should be given for wounds received during mass casualty settings. If completion of a primary tetanus series is in doubt, tetanus immune globulin (TIG) should also be given. TIG is most likely to be needed by the elderly and immigrants from areas of the world other than North America and Europe.
These recommendations pertain only to bombings and other mass-casualty events and are not meant to take the place of existing recommendations for administering vaccines in other health care settings.
For the full text of the report, visit; or contact Journals@Ovid platform.

Friday, Oct. 17, 2008

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