CLINICAL LAB SCIENEC

CHAPTER 6: INTRODUCTION TO INFECTION CONTROL 139
the organism, should be available for postexposure treatment. If HBIG is to be
used, it should be given as soon as possible and always within 7 days following
an exposure incident. An exposure through a needle stick injury would be of
the most concern and would provide the greatest potential for transmitting the
organism from a patient to the health care worker. Blood splashes to the eyes or
blood or other body fluids that contaminate cuts , rashes, and abrasions on the
hands would also give cause for concern.
Situations where contact with blood or other potentially infectious materials
occur should be carefully evaluated. The source patient should be considered for
testing if available to determine if blood came from an infected patient. Remember,
a source patient does not have to agree to have his or her blood collected
and tested.
Prevention of hepatitis has been readily available for more than 20 years.
HBV vaccine is provided by the employer in health care facilities and other agencies
where a high likelihood exists for coming in contact with the virus. Although
a worker may decline the immunization, it is highly recommended for persons
considered to be at high risk for contracting this illness, particularly for health
care workers. Immunization for HBV leaves few side effects and is the most
effective and specific way to avoid contracting the illness.
Prehospital health care personnel, such as emergency treatment personnel,
are considered to be in the high-risk category. These emergency responders are
required to either undergo the three-dose immunization or to sign a declination
form stating that the risks are known but that the worker does not wish to be
immunized. HBV infections are often accompanied by hepatitis C viral infections.
Although only approximately 10% of hepatitis B–infected persons become
chronically infected, hepatitis C has more long-term effects. One serious longterm
effect of hepatitis C is the statistical increase in liver cancer among those
who were infected even decades earlier. Often, the contraction of hepatitis B and
hepatitis C occurs simultaneously, along with several other lesser-known viruses
known to cause hepatitis (most common are the delta and echo varieties).
Tuberculosis in the Health Care Setting
By virtue of working with patients who are ill, and those particularly who have
some sort of compromising condition of the immune system, such as HIV infections,
health care providers are at particular risk for contracting tuberculosis
(TB). Therefore, education and training on a regular basis are required for persons
with direct patient contact and those who handle items that may have
become contaminated by patients.
Introduction to Tuberculosis
A number of airborne pathogens exist, and the medical worker or student is
exposed to many organisms that may be transmitted through the respiratory
tract. TB, however, is the only disease currently included in federal guidelines for
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