New Recommendations To Protect Disaster Survivors

Main Category: Aid / Disasters
Article Date: 06 Aug 2008 - 0:00 PDT

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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 latest 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 (CDC).

"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 MD, 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 wounds."

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.
- 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.

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.

This article is available ahead of print online the full journal will publish on October 9, 2008. There will be a special issue published on Sept. 9, 2008.

Note to reporters: To obtain complete online access to the journal, contact AMA Media Relations at (312) 464-4813 and provide appropriate press credentials. The AMA's Disaster Medicine and Public Health Preparedness journal maintains editorial independence and the statements and opinions in the journal, including the articles referenced above, are not those of the AMA or Lippincott Williams & Wilkins.

About AMA's Disaster Medicine and Public Health Preparedness Journal

The AMA Disaster Medicine and Public Health Preparedness journal was created to promote public health preparedness and the science of disaster medicine. It is the first comprehensive, peer-reviewed publication emphasizing public health preparedness and disaster response. The journal is published for the AMA by leading health care publisher Lippincott Williams & Wilkins. An online version can be found on the Web at http://www.dmphp.org and is also available on the Journals@Ovid platform.

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