Viruses health care workers

Yes. Vaccinia vaccine is recommended for laboratory workers who directly handle cultures, animals contaminated or infected with, nonhighly attenuated vaccinia virus, recombinant vaccinia viruses derived from nonhighly attenuated vaccinia strains, or other orthopoxviruses that infect humans. These would include monkeypox, cowpox, vaccinia, and variola. Other health-care workers, such as physicians and nurses whose contact with nonhighly attenuated vaccinia viruses is limited to contaminated materials such as medical dressings but who adhere to appropriate infection control measures, are at lower risk for accidental infection than laboratory workers. However, because a theoretical risk for infection exists, vaccination can be offered to this group. Vaccination is not recommended for people who do not directly handle nonhighly attenuated virus cultures or materials or who do not work with animals contaminated or infected with these viruses. 

Lamivudine may be used prophylactically in health care workers at risk of acquiring HIV infection after occupational exposure to the virus and in combination with zidovudine for treatment of HIV infection. 

In addition to oral administration for hepatitis C infection in combination with interferon alfa, aerosolized ribavirin is administered by nebulizer (20 mg/mL for 12-18 hours per day) to children and infants with severe respiratory syncytial virus (RSV) bronchiolitis or pneumonia to reduce the severity and duration of illness. Aerosolized ribavirin has also been used to treat influenza A and infections but has not gained widespread use. Systemic absorption is low (< 1%). Aerosolized ribavirin is generally well tolerated but may cause conjunctival or bronchial irritation. Health care workers should be protected against extended inhalation exposure. The aerosolized drug may precipitate on contact lenses. 

The recommendations state that hospitals should vaccinate enough staff in each category to ensure continuity of care (32). Health care workers performing the vaccinations should first receive the vaccine to minimize the consequences of inadvertent inoculation. Laboratory workers are not included in the recommendations because the quantity of smallpox virus likely to be present in clinical specimens is low. 

In addition to vaccinating health care workers against hepatitis B, other infection control practices are important in preventing transmission of the virus because up to 10% of people do not develop an adequate antibody response to the vaccine. The most important infection control measure is the use of universal precautions. These precautions prevent exposure to blood and blood-derived body fluids via use of a variety of barrier precautions, measures to prevent needlesticks, environmental control measures, and good hand-washing techniques. However, if a worker is exposed to material that potentially contains HBV, recommendations for percutaneous exposure to HBV should be followed (see Table 40-7). ... 

With respect to transmission among health care workers (HCW), from HCW to the patients or in hospital setting in general, the major motif for the spread of the virus is the non-compliance with recommended infection control practices, shown again in the studies of Simonsen et al. (1999) and Kane et al. (1999). 

Nosocomial transmission refers to the spread of a disease within a health-care setting, such as a clinic or hospital. It occurs frequently during Ebola HF outbreaks. It includes both types of transmission described above. In African health-care facilities, patients are often cared for without the use of a mask, gown, or gloves. Exposure to the virus has occurred when health care workers treated individuals with Ebola HF without wearing these types of protective clothing. In addition, when needles or syringes are used, they may not be of the disposable type, or may not... 

The types of hantavirus that cause HPS in the United States cannot be transmitted from one person to another. For example, you cannot get the virus from touching or kissing a person who has HPS, or from a health care worker who has treated someone with the disease. Finally, you cannot get the virus from a blood transfusion in which the blood came from a person w ho became ill with HPS and survived. 

Nerad JL, Kessler HA. Hypercholesterolemia in a health care worker receiving th3(roxme after postexposure prophylaxis for human immunodeficiency virus infection. Clin InfectDis (2001)... 

Health care workers are at risk of tuberculosis (TB), hepatitis B and C viruses, and the humem immunodeficiency virus (HIV). Socieil service workers, corrections personnel, md other occupationed groups who work reguMy with populations having increased rates of TB may eilso face increased risk. Laboratory workers ace at risk of exposure to infectious diseases when working with infective materieil. 

Each day health care workers are exposed to many types of hazards. The main ones are shown in Figure 7.2 [8]. These are infectious hazards, physical hazards, environmental hazards, chemical hazards, and psychosocial/psy-chological hazards (i.e., emotional stress). Infectious hazards are basically concerned with various types of infections. Health care workers are exposed routinely to many types of infectious hazards, particularly blood-borne pathogens. Over the past few decades, blood-borne pathogens have received increasing attention because of the focus on the human immunodeficiency virus (HIV), which can resulf in acquired immune deficiency S5mdrome (AIDS) [8]. 

Around 50 to 247 health care workers get infected with hepatitis C virus (HCV) from work-related needlesticks each year in the United States [12]. 

Ippolito G, Puro V, DeCarli G, et al. (1993) The risk of occupational human immunodeficiency virus infection in health care workers. Arch Intern Med 155 1451-1458... 

CDC (1987) Update human immunodeficiency virus infections in health-care workers exposed to blood of infected patients. MMWR 36 285-289... 

Bernard L, Steinbrook R (1992) Health care workers infected with the human immunodeficiency virus. JAMA 267 1100-1105... 

Gerberding, J.L., C.E. Bryant-LeBlanc, K. Nelson, A.R. Moss, D. Osmond, H.F. Chambers, J.R. Carlson, W.L. Drew, J.A. Levy, and M.A. Sande. 1987. Risk of transmitting the human immunodeficiency virus, cytomegalovirus, and hepatitis B virus to health care workers exposed to patients with AIDS and AIDS-related conditions./. Infect. Dis. 156 1-8. 

National Institute for Occupational Safety and Health. Guidelines for Prevention of Transmission of Human Immunodeficiency Virus and Hepatitis B Virus of Health-Care and Pubhc Safety Workers. DHSS (NIOSH) Pubhcation No. 89-107. Washington DC ... 

Each year more than 1000 workers in the area of health care in the United States will contract a serious infection such as HIV or hepatitis B or C virus from needlestick injuries [12]. 

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