Blood borne virus transmission
Victims of bomb blasts, rescuers, and responders, can suffer penetrating injuries as well as body part (bone) implantation injuries with potential for transmission of blood-borne viruses (BBV).
Consider this advice also in patients who have had contact with blood on their mucous membranes/non-intact skin.
Blood borne viruses include: Hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV.
Recommended actions:
- Examine wounds with radiographs and arrange urgent removal of any human body implantations.
- Take and store blood specimens from victims of human projectile injury before any specific post-exposure treatment is initiated.
- All patients who have suffered human projectile injuries which have breached the skin should receive post-exposure vaccination with Hepatitis B vaccine:
- rapid schedule (0, 1 and 2 months OR 0, 7, 21 days and 12 months)
- first dose should ideally be given within 48 hours of injury (can be provided up to 7 days after injury)
- Perform post-exposure testing of blast victims for HBV, HCV and HIV at 3 and 6 months
HIV PEP is rarely indicated. Consult ID Micro for advice. See also HIV PEP and PEPSE: post exposure prophylaxis
Desirable: Specimens should be taken from the scene, at post-mortems and from survivors to assess the risk of BBV
For anyone who has been transferred to another NHS Trust, ensure that this information is sent to the receiving team.
For anyone who has been seen and discharged from care, either call the patient back for follow-up as advised, or contact the patient's GP urgently for timely follow-up.