Hepatitis: Payne L

Puro V, De Carli G, Cicalini S, Soldani F, Balslev U, Begovac J, Boaventura L, Campins Martí M, Hernández Navarrete MJ, Kammerlander R, Larsen C, Lot F, Lunding S, Marcus U, Payne L, Pereira AA, Thomas T, Ippolito G, Anonymous00733. · Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, IRCCS, Rome, Italy. · Euro Surveill. · Pubmed #16282641 links to  free full text

Abstract: Exposure prevention is the primary strategy to reduce the risk of occupational bloodborne pathogen infections in healthcare workers (HCW). HCWs should be made aware of the medicolegal and clinical relevance of reporting an exposure, and have ready access to expert consultants to receive appropriate counselling, treatment and follow-up. Vaccination against hepatitis B virus (HBV), and demonstration of immunisation before employment are strongly recommended. HCWs with postvaccinal anti-HBs levels, 1-2 months after vaccine completion, >or=10 mIU/mL are considered as responders. Responders are protected against HBV infection: booster doses of vaccine or periodic antibody concentration testing are not recommended. Alternative strategies to overcome non-response should be adopted. Isolated anti-HBc positive HCWs should be tested for anti-HBc IgM and HBV-DNA: if negative, anti-HBs response to vaccination can distinguish between infection (anti-HBs >or=50 mUI/ml 30 days after 1st vaccination: anamnestic response) and false positive results(anti-HBs >or=10 mUI/ml 30 days after 3rd vaccination: primary response); true positive subjects have resistance to re-infection. and do not need vaccination The management of an occupational exposure to HBV differs according to the susceptibility of the exposed HCW and the serostatus of the source. When indicated, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible (within 1-7 days). In the absence of prophylaxis against hepatitis C virus (HCV) infection, follow-up management of HCV exposures depends on whether antiviral treatment during the acute phase is chosen. Test the HCW for HCV-Ab at baseline and after 6 months; up to 12 for HIV-HCV co-infected sources. If treatment is recommended, perform ALT (amino alanine transferase) activity at baseline and monthly for 4 months after exposure, and qualitative HCV-RNA when an increase is detected.

Payne L, Coulombier D. · No affiliation provided · Euro Surveill. · Pubmed #19161730 links to  free full text

Abstract: In the European Union (EU), the overall incidence of hepatitis A has decreased over the last 10 years from 15.1 per 100,000 population in 1996 to 3.9 per 100,000 in 2006. However, reduction in circulation of HAV leads to decreased acquisition of immunity and, in the absence of universal vaccination, an accumulation of susceptible individuals. The impact of increasing susceptibility of the general population on the risk for outbreaks is clearly illustrated in independent outbreaks in Czech Republic, Latvia and Slovakia in 2008, described in three of the articles published in this week s issue of Eurosurveillance.

Abdelmagid OY, Larson L, Payne L, Tubbs A, Wasmoen T, Schultz R. · Schering-Plough Animal Health, Research and Development, 21401 West Center Road, Elkhorn, NE 68022, USA. · Vet Ther. · Pubmed #15578450 No free full text.

Abstract: The results of this study confirmed that dogs vaccinated subcutaneously with a commercially available multivalent vaccine containing modified-live canine distemper virus, canine adenovirus type 2, canine parvovirus type 2b, and canine parainfluenza virus antigens were protected against sequential experimental challenge 55 to 57 months after initial vaccination given at 7 to 8 weeks of age. All 10 vaccinates were protected against clinical diseases and mortality following parvovirus and infectious canine hepatitis experimental infections. All vaccinates were protected against mortality and 90% against clinical disease following distemper challenge. These data support at least a 4-year duration of immunity for these three "core" fractions in the combination vaccine.