![]() These vaccine-related recommendations, paired with greater needle safety and improved use of standard precautions, led to a dramatic decline in the number of occupational HBV infections, with HBV infections among HCP falling by 98% between 19 ( Figure 2). In 1991, given the ongoing risk for HBV infection among health care personnel who do not respond to the hepatitis B vaccine series, the ACIP recommended consideration of postvaccination serologic testing for HBV in health care personnel at risk for needlestick exposures, and in 1997 ultimately recommended universal HBV postvaccination serologic testing 1 to 2 months after completing the hepatitis B vaccine series for all HCP who have ongoing risk for occupational exposure. In 1983, there were approximately 17,000 HBV infections among HCP, which corresponded to a three-fold higher incidence than in the general population. Soon after the first vaccines to prevent HBV infection became available in 1981, the Advisory Committee on Immunization Practices (ACIP) recommended routine vaccination of HCP. Occupational HBV in the United StatesÄuring the 1970s, serologic studies conducted in the United States reported a seroprevalence of HBV among HCP approximately 10 times higher than in the general population. Beginning in the early 1980s, several key developments, recommendations, and policy changes have resulted in a marked reduction in the risk of HCP acquiring HBV in the United States ( Figure 1). For HCP, the potential to acquire HBV via occupational exposure is of particular concern and preventing occupational HBV acquisition is a high priority in the United States health care system. Hepatitis B is a highly infectious blood-borne pathogen that can remain viable on environmental surfaces for at least 7 days and can be transmitted even in the absence of visible blood. Health care personnel (HCP) are at risk for a variety of infectious pathogens following exposure to blood or body fluids, including hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Data for Occupational Postexposure Prophylaxis for HBV.Postexposure Prophylaxis for HBV in Perinatal Setting.Efficacy of Occupational Postexposure Prophylaxis for HBV.Special Precautions to Prevent Secondary Transmission.Monitoring of HCP after Occupational HBV Exposure. ![]() Unvaccinated or Incompletely Vaccinated HCP.Vaccinated HCP and Response Unknown after Complete Vaccine Series.Vaccinated HCP who has not responded after Two Vaccine Series.Vaccinated HCP with Vaccine-Induced Immunity.Management of Occupational Exposure to HBV.Interventions for HBV Occupational Postexposure Prophylaxis.Determining the HBV Status of the Source Patient.Determining the HBV Immune Status of the HCP.Determining the Type and Nature of the Exposure.Initial Approach to Postexposure Prophylaxis.Relative Risk of Infectious Body Fluids.Risk of HBV with Occupational Exposures.Definition of Health Care Personnel (HCP).Occupational HBV Postexposure Prophylaxis.
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