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
• Administer post-exposure vaccination with HBV vaccine: 
• rapid schedule (0, 1 and 2 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  PEP - Post-exposure Prophylaxis for Paediatrics

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, please ensure that this information is sent to the receiving team. For anyone who has been seen and discharged from care, please either call the patient back for follow-up as advised, or contact the patient's GP urgently for timely follow-up.