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
“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
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.
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.
- 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.
For the full text of the report, visit http://www.dmphp.org;
or contact Journals@Ovid platform.
Friday, Oct. 17, 2008