Recommendations for Postexposure Interventions to Prevent Infection with Hepatitis B Virus, Hepatitis C Virus, or Human Immunodeficiency Virus, and Tetanus in Persons Wounded During Bombings and Other Mass-Casualty Events — United States, 2008. Recommendations of the Centers for Disease Control and Prevention (CDC)
Louisa E. Chapman 1*,
Ernest E. Sullivent 1,
Lisa A. Grohskopf 1,
Elise M. Beltrami 1,
Joseph F. Perz 1,
Katrina Kretsinger 1,
Adelisa L. Panlilio 1,
Nicola D. Thompson 1,
Richard L. Ehrenberg 1,
Kathleen F. Gensheimer 1,
Jeffrey S. Duchin 1,
Peter H. Kilmarx 1,
Richard C. Hunt 1
1 Immunization Services Division, National Center for Immunizations and Respiratory Diseases; Division of Injury Response, National Center for Injury Prevention and Control; Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and Control of Infectious Diseases; Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases; Office of Emergency Preparedness and Response, National Institute for Occupational Safety and Health; Council of State and Territorial Epidemiologists, Atlanta, Georgia; Maine Department of Health and Human Services, Augusta, Maine; National Association of County and City Health Officials, Washington, DC; Public Health - King County, Seattle, Washington
* To whom correspondence should be addressed. E-mail: LChapman{at}cdc.gov.
 |
Abstract |
|---|
This report outlines recommendations for postexposure interventions to prevent infection with hepatitis B virus, hepatitis C virus, or human immunodeficiency virus, and tetanus in persons wounded during bombings or other events resulting in mass casualties. Persons wounded during such events or in conjunction with the resulting emergency response might be exposed to blood, body fluids, or tissue from other injured persons and thus be at risk for bloodborne infections. 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 CDC's Terrorism Injuries: Information, Dissemination and Exchange (TIIDE) project. The recommendations contained in this report represent the consensus of U.S. 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.
