Employee/Occupational Health (11 questions) Flashcards
Vaccine Preventable Diseases
Hepatitis A and B
Influenza
Measles
Mumps
Rubella
Tetanus and diphtheria
Pertussis
Polio
Varicella-zoster (chickenpox)
Post-Exposure Intervention Diseases
Tuberculosis
Rubella
Meningitis (Neisseria meningitidis)
Hepatitis A, B
Varicella-zoster (chickenpox)
Scabies
Pertussis
Human immunodeficiency virus
No Post-Exposure Intervention Diseases
Herpes simplex
Cytomegalovirus
Meningitis other than N. meningitidis
Respiratory Syncytial Virus (RSV)
Rotavirus
Hepatitis C
Conversion Positive result for TB
HCW with exposure to TB with an increase of ≥10 mm TST
Post exposure skin testing TB
Done at time of exposure and 12 weeks post exposure
- CXR only if prior + TST or symptomatic
- Cutaneous anergy= condition that causes inability to react to skin test because of altered immune function
- immunocompromised: consider retesting every 6 months because of inability to react to Mantoux
proof of immunity to measles,
mumps, and rubella
vaccination with one or more
doses of live vaccine, lab evidence of
immunity, or history of these diseases.
Although birth before 1957 is considered acceptable
evidence of MMR immunity, ACIP recommends
that healthcare facilities consider vaccinating unvaccinated personnel born
before 1957 who do not have laboratory evidence of measles, rubella, and
mumps immunity; laboratory confirmation of disease; or vaccination with two
appropriately spaced doses of MMR vaccine for measles and mumps and one
dose of MMR vaccine for rubella
MMR
live virus, dont administer if preg or will become preg in 30 days
measles- give to HCW within 72 hours post exposure, no work 5 days after 1st exposure to 21 days after last
Meningococcal Meningitis
- pre-exposure offered to lab who handle speciments
- PEP: if intensive, unprotected (no mask) contact.
PEP meds:
Adult (not preg): cipro orally
child, preg: cefotaxime IM
child or adult: Rifampin
Measles exposure
vax given to susceptible workers within 72 hours exposure, no work 5 days after 1st exposure to 21 days after last exposure
Measles is caused by the Rubeola virus and is a highly contagious, respiratory infection. The MMR vaccine, or Measles, Mumps, and Rubella vaccine, is required for all healthcare workers who were born in 1957 or after and do not have serological evidence of immunity. Healthcare workers who are exposed to measles virus and do not have documented evidence of immunity should receive the MMR vaccine within 72 hours of the exposure, and should be excluded from work for the duration of the incubation period of the virus, which is 5 to 21 days.
Hep A work restrictions
restrict from pt contact or food handling until 7 days after onset jaundice
Hep B and HIV work restrictions
restrict if have exposure prone job, otherwise refer to state regulations. If no exposure prone job then no restrictions
Varicella exposure
test for antibodies if no hx of chickenpox.
If - or inadequate titer: exclude from work 10-20 days post exposure (28th day VZIG adm) or if conversion to + then until all lesions are dry or crusted over
HBsAG neg and IGM anti-HBC neg
not currently infeted with Hep B
Total anti-HBc + and anti-HBs +
had Hep B in the past
Human normal immunoglobulin preparations are available for
hepatitis A, measles, polio and rubella; there are also specific immunoglobulin preparations for hepatitis B, rabies and varicella-zoster
Employees that experience a needlestick or sharps injury or who are exposed to blood or other body fluids must immediately follow these steps:
- Immediately seek medical treatment (ED)/first aid or Wash needlesticks and cuts with soap and water
- Flush splashes to the nose, mouth, or skin with water
- Irrigate eyes with clean water, saline, or sterile irrigants
- Report the incident to your supervisor
immunizations recommended for all healthcare personnel who have direct patient contact
Tdap
The Tetanus, Diphtheria, Pertussis vaccine (Tdap) protects against these three different infections. For healthcare workers, the Pertussis component of the vaccine is especially critical because this is a communicable disease and the prevalence of Pertussis in the United States and other developed countries has been trending upward. Pertussis can cause serious respiratory illness, especially in babies under one year of age.
Hep C risk of getting after exposure
Hepatitis C infection is the most common chronic bloodborne infection in the United States. It is primarily transmitted through injection drug use and needle-sharing and may be transmitted through sharp object injury in a healthcare setting. There is no vaccine for Hepatitis C so infection prevention relies on preventing sharp object injuries to healthcare workers. While there are various factors that contribute to overall risk of acquiring Hepatitis C after a sharp object injury, including the depth of the puncture and whether the source needle had been in a blood vessel, the overall risk of acquiring Hepatitis C after exposure is approximately 1.8%
A TST reaction of ≥5 mm of induration is considered positive in:
-HIV-infected persons
-Recent contacts of a person with infectious TB disease
-Persons with fibrotic changes on chest radiograph consistent with prior TB
-Patients with organ transplants and other immunosuppressed patients (including patients taking the equivalent of ≥15 mg/day of prednisone for 1 month or more or those taking TNF-α antagonists)
A TST reaction of ≥10 mm of induration is considered positive in the following individuals:
-Recent arrivals to the United States (within last 5 years) from high-prevalence areas
-Injection drug users
-Residents or employees of high-risk congregate settings (e.g., correctional facilities, long-term care facilities, hospitals and other health care facilities, residential facilities for patients with HIV infection/AIDS, and homeless shelters)
-Mycobacteriology laboratory personnel
-Persons with clinical conditions that increase the risk for progression to TB disease
-Children younger than 5 years of age
Infants, children, and adolescents exposed to adults in high risk categories
TST reaction of ≥15 mm of induration is considered positive in the following individuals
Persons with no known risk factors for TB
HCW without exposure to TB needs ?mm TST for a positive conversion result
> 10 mm
A healthcare worker without known
exposure who demonstrates an increase of ≥10 mm is considered a positive
result.
An employee who is not immune to varicella-zoster was exposed
to a patient with active chickenpox. How long must the employee
remain on work restrictions?
should be excluded
from work duty from the 10th day after the first day of exposure through the
21st days after the last exposure
appropriate temperature for vaccines that require refrigeration
35°F to 46°F (2°C to 8°C)
Most routinely recommended vaccines should be stored in a
refrigerator between 35°F and 46°F (2°C and 8°C), with a desired average
temperature of 40°F (5°C). Exposure to temperatures outside this range
may result in reduced vaccine potency and increased risk of vaccine preventable
diseases.
