Program Manual - Saint Louis University

E. Hepatitis A
1. Definition of exposure: Disease is transmitted via the fecal oral route. Fecal oral exposures should not occur
if standard Infection Control policies and procedures are followed. Because of this, Hepatitis A vaccine is not
routinely offered to healthcare workers. Healthcare workers requesting Hepatitis A vaccination are referred to
the private medical care provider.
2. Asymptomatic exposed HCWs should receive passive immunization with immune globulin. IG 0.02 ml/kg is
given IM as soon as possible after the exposure but within two weeks of exposure.
3. Symptomatic exposed HCWs are evaluated and treated at Employee Health.
F. Herpes
1. Definition of exposure: Direct contact with mucous membrane lesions or virus-containing secretions.
2. Asymptomatic exposed HCWs need no intervention.
3. Symptomatic exposed HCWs are evaluated and treated at Employee Health.
G. Measles
1. Definition of exposure: Airborne by droplet spread. Direct contact with nasal or throat secretions. This can
also include direct contact with articles freshly soiled with nose or throat secretions.
2. Susceptible HCWs include those who have not had the disease, those with a negative measles titer, or those
who have not been successfully immunized with two doses of live measles vaccine on or after their first
birthday and at least one month apart.
3. Asymptomatic susceptible exposed HCWs are evaluated with a Measles titer.
a. If the measles titer is positive, HCWs need no intervention.
b. If the measles titer is negative or pending, asymptomatic susceptible exposed HCWs are unable to work
from the fifth through the 21st day after exposure. Asymptomatic susceptible exposed HCWs may
receive MMR vaccine within 72 hours of exposure at Employee Health. This may provide protection.
Immune globulin (IG) may be used within 6 days of exposure for pregnant HCWs or HCWs for whom
measles vaccination is contraindicated. IG 0.25 ml/kg up to a maximum of 15 ml. Immune globulin (IG)
may be used within 6 days of exposure for immunocompromised HCWs. IG 0.5 ml/kg up to a maximum
of 15 ml.
4. Symptomatic susceptible exposed HCWs are evaluated and treated at Employee Health.
H. Meningococcal Disease including meningitis
1. Definition of exposure: Direct contact with respiratory droplets from nose and mouth.
2. Asymptomatic exposed HCWs are treated with an appropriate antimicrobial agent as prophylaxis.
Prophylaxis should be administered as soon as possible after exposure. Prophylaxis administered later than
14 days after exposure is of limited or no value. If an exposure occurs when the Employee Health office is
closed, the exposed employees are evaluated and treated in SLUHospital Emergency Room.
3. Symptomatic exposed HCWs should report immediately for evaluation to Employee Health or to
SLUHospital Emergency Room if it is after hours. Symptoms include: intense headache, fever, nausea, stiff
neck, or petechial rash.
I. Mumps
1. Definition of exposure: Direct contact with the saliva and respiratory droplets from the nose and mouth.
2. Susceptible HCWs include those who have not had the disease or who have not been successfully immunized
with one dose of live mumps vaccine on or after the first birthday.
3. Asymptomatic susceptible exposed HCWs are unable to work from the 12th through the 25th day after
exposure.
4. Symptomatic susceptible exposed HCWs are evaluated and treated at Employee Health.
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