Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis.

This report updates US Public Health Service recommendations for the management of healthcare personnel (HCP) who experience occupational exposure to blood and/or other body fluids that might contain human immunodeficiency virus (HIV). Although the principles of exposure management remain unchanged, recommended HIV postexposure prophylaxis (PEP) regimens and the duration of HIV follow-up testing for exposed personnel have been updated. This report emphasizes the importance of primary prevention strategies, the prompt reporting and management of occupational exposures, adherence to recommended HIV PEP regimens when indicated for an exposure, expert consultation in management of exposures, follow-up of exposed HCP to improve adherence to PEP, and careful monitoring for adverse events related to treatment, as well as for virologic, immunologic, and serologic signs of infection.

Performance evaluation of selected n95 respirators and surgical masks when challenged with aerosolized endospores and inert particles.

The objective of this study was to assess how the relative efficiency of N95 respirators and surgical masks might vary with different challenge aerosols, utilizing a standardized manikin head form as a surrogate to human participation. A Collision nebulizer aerosolized B. anthracis Sterne strain endospores and polystyrene latex (PSL) particles to evaluate 11 models of N95 respirators and surgical masks.

Assessment of management policies and practices for occupational exposure to bloodborne pathogens in dialysis facilities.

Background: Occupational exposure management is an important element in preventing the transmission of bloodborne pathogens in health care settings. In 2008, the US Centers for Disease Control and Prevention conducted a survey to assess procedures for managing occupational bloodborne pathogen exposures in outpatient dialysis facilities in the United States.

Study Design: A cross-sectional survey of randomly selected outpatient dialysis facilities.

Effectiveness of selected surgical masks in arresting vegetative cells and endospores when worn by simulated contagious patients.

Objective: The objective of this study was to quantify the effectiveness of selected surgical masks in arresting vegetative cells and endospores in an experimental model that simulated contagious patients.

Setting: Laboratory.

Methods: Five commercially available surgical masks were tested for their ability to arrest infectious agents.

Feasibility of selected prophylactic barriers in arrestance of airborne bacterial vegetative cells and endospores.

Background: Transmission of infection by airborne agents is a risk for health care personnel, patients, and visitors. This risk is heightened in regions without access to environmental controls and personal protective equipment. The ability of 2 prophylactic barriers (ie, semitransparent netting for insect control) to arrest bioaerosols was assessed for potential use within the malarial zones.

Tuberculosis epidemiology, diagnosis and infection control recommendations for dental settings: an update on the Centers for Disease Control and Prevention guidelines.

Background: Although rates of tuberculosis (TB) in the United States have decreased in recent years, disparities in TB incidence still exist between U.S.-born and foreign-born people (people living in the United States but born outside it) and between white people and nonwhite people.

Postexposure interventions to prevent infection with HBV, HCV, or HIV, and tetanus in people wounded during bombings and other mass casualty events--United States, 2008: recommendations of the Centers for Disease Control and Prevention and Disaster Medicine and Public Health Preparedness.

People wounded during bombings or other events resulting in mass casualties or in conjunction with the resulting emergency response may be exposed to blood, body fluids, or tissue from other injured people and thus be at risk for bloodborne infections such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or tetanus. This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass casualty event. Decisions regarding the implementation of prophylaxis are complex, and drawing parallels from existing guidelines is difficult.

Recommendations for postexposure interventions to prevent infection with hepatitis B virus, hepatitis C virus, or human immunodeficiency virus, and tetanus in persons wounded during bombings and other mass-casualty events--United States, 2008: recommendations of the Centers for Disease Control and Prevention (CDC).

This report outlines recommendations for postexposure interventions to prevent infection with hepatitis B virus, hepatitis C virus, or human immunodeficiency virus, and tetanus in persons wounded during bombings or other events resulting in mass casualties. Persons wounded during such events or in conjunction with the resulting emergency response might be exposed to blood, body fluids, or tissue from other injured persons and thus be at risk for bloodborne infections. This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass-casualty event.

Costs of management of occupational exposures to blood and body fluids.

Objective: To determine the cost of management of occupational exposures to blood and body fluids.

Design: A convenience sample of 4 healthcare facilities provided information on the cost of management of occupational exposures that varied in type, severity, and exposure source infection status. Detailed information was collected on time spent reporting, managing, and following up the exposures; salaries (including benefits) for representative staff who sustained and who managed exposures; and costs (not charges) for laboratory testing of exposure sources and exposed healthcare personnel, as well as any postexposure prophylaxis taken by the exposed personnel.

Widespread outbreak of norovirus gastroenteritis among evacuees of Hurricane Katrina residing in a large "megashelter" in Houston, Texas: lessons learned for prevention.

Background: After Hurricane Katrina, an estimated 200,000 persons were evacuated to the Houston metropolitan area, >27,000 of whom were housed in 1 large "megashelter," the Reliant Park Complex. We investigated an outbreak of gastroenteritis reported among the evacuees who resided in the Reliant Park Complex to assess the spread of the infectious agent, norovirus, and to implement and evaluate the effectiveness of interventions used for control.

Methods: Public health authorities conducted surveillance of gastroenteritis among evacuees treated at the Reliant Park Medical Clinic during 2-12 September 2005.

Preventing percutaneous injuries among dental health care personnel.

Background: The Occupational Safety and Health Administration and the Centers for Disease Control and Prevention (CDC) recommend that health care personnel (HCP) adopt safer work practices and consider using medical devices with safety features. This article describes the circumstances of percutaneous injuries among a sample of hospital-based dental HCP and estimates the preventability of a subset of these injuries: needlesticks.

Methods: The authors analyzed percutaneous injuries reported by dental HCP in the CDC's National Surveillance System for Health Care Workers (NaSH) from December 1995 through August 2004 to describe the circumstances.

Updated U.S. Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis.

This report updates U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain human immunodeficiency virus (HIV).

Factors influencing health care workers' adherence to work site tuberculosis screening and treatment policies.

Background: Despite the known risk of tuberculosis (TB) to health care workers (HCWs), research suggests that many are not fully adherent with local TB infection control policies. The objective of this exploratory study was to identify factors influencing HCWs' adherence to policies for routine tuberculin skin tests (TSTs) and treatment of latent TB infection (LTBI).

Methods: Sixteen focus groups were conducted with clinical and nonclinical staff at 2 hospitals and 2 health departments.

Estimate of the annual number of percutaneous injuries among hospital-based healthcare workers in the United States, 1997-1998.

Objective: To construct a single estimate of the number of percutaneous injuries sustained annually by healthcare workers (HCWs) in the United States.

Design: Statistical analysis.

Methods: We combined data collected in 1997 and 1998 at 15 National Surveillance System for Health Care Workers (NaSH) hospitals and 45 Exposure Prevention Information Network (EPINet) hospitals.

Tuberculin skin testing surveillance of health care personnel.

To estimate the incidence of and assess risk factors for occupational Mycobacterium tuberculosis transmission to health care personnel (HCP) in 5 New York City and Boston health care facilities, performance of prospective tuberculin skin tests (TSTs) was conducted from April 1994 through October 1995. Two-step testing was used at the enrollment of 2198 HCP with negative TST results. Follow-up visits were scheduled for every 6 months.