Policy Manual sample

MDT Home Health Care Agency, Inc. HIV AND HEPATITIS INFORMATION SHEET HIV INFECTION HIV-AIDS the human immunodeficiency virus is the “newest” of the major blood borne diseases. General appearance and medical history cannot identify the patient who may be HIV positive. Symptoms of HIV may include weakness, fever, sore throat, nausea, headaches, diarrhea, and other flue-like symptoms. Many people with the HIV virus can show no symptoms for years. In most cases, contracting the HIV virus leads to breakdown of the immune system leaving the body with no way to fight infection and other diseases. At this time there is no vaccination to prevent HIV and there is no common cure. HEPATITIS INFECTION Hepatitis is an inflammation of the liver. The form of viral hepatitis, formerly called “serum hepatitis”, is caused by the Hepatitis B virus (HBV). This form of viral hepatitis, which is the major cause of acute and chronic hepatitis, cirrhosis and primary hepatocellular carcinoma, is transmitted by intimate exposure to infectious blood or serum derived fluids, semen, vaginal secretions, or saliva. In the workplace, exposure is parenteral, or by contact with mucous membranes or non-intact skin, most commonly by needle stick or sharps accident, or by containation of unapparent breaks in the skin. Also contaminated fomites play a role in HBV transmission. Approximately 0.2-0.9% of adults in the U.S., and greater than 1% of hospitalized patients, are infectious for Hepatitis B. Hepatitis B infection is the major infectious occupational hazard to healthcare workers, causing approximately 12,000 infections, 3,000 cases of acute clinical illness, 600 hospitalizations, 1,000 chronic carriers, and 200 deaths annually. Without pre or post-exposure prophylaxis, 6-30%of non- immune healthcare workers who sustain an exposure from an infectious source develop Hepatitis B infection. The use of Hepatitis B vaccine and other appropriate environmental controls can prevent almost all occupational infection. THE VACCINE Hepatitis B vaccine (recombinant) is a non-infectious, recombinant DNA Hepatitis B vaccine produced in yeast cells. The yeast derived vaccines contain no human plasma so there is absolutely no possibility that they can cause HIV infection. This was a concern, without merit, with the previous vaccine derived by inactivated antigen from the plasma of chronic HBV carriers. The vaccine is given in a series of three (3) doses over a six (6) month period. The vaccine induces protective antibody levels in 85-97% of healthy adults completing the series. SIDE-EFFECTS No serious effects have been noted, however, it is possible that with expanded use, rare adverse reactions may become noted. In studies, 22% noted soreness at the site, 14% noted fatigue. Fewer persons experienced fever, joint pain, local reaction rash, headache or dizziness. CONTRAINDICATIONS Hypersensitivity to yeast or any other components of the vaccine. Immunocompromised persons, e.g., hemodialysis patients, those receiving immunosuppressive drugs, or those with HIV infection, may not develop protective antibody levels with the course recommended for healthcare workers and would need special monitoring. Product literature states that it is not known whether the vaccine causes fetal harm and should only be given to a pregnant woman if clearly needed and caution should be used during administration to nursing mothers. The CDC states that since HBV infection in a pregnant woman may result in severe disease for the mother and newborn, and since the vaccine contains only non-infectious HbsAG particles, hence there should be no risk to the fetus, that neither pregnancy nor lactation should be considered a contraindication. The APHA states, “Pregnancy is not definitive contraindication for receiving the inactivated vaccine.” DEFERRALS Those with known hypersensitivity to yeast; Home Health Agency Policies A-50