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Infectious Diseases

Answer 3
  1. Administer IG to all previously unvaccinated staff and day care attendees. In the case of HAV infection in a day care employee or attendee, IG should be administered to all previously unvaccinated staff and attendees of the day care center. IG also should be considered for employees or households of day care attendees that have children in diapers. IG provides protection against HAV through passive transfer of antibody. IG, either administered IM or intravenously, contains anti-HAV, but IG administered IM is used for the prevention of HAV infection. Poor hygiene among children who wear diapers and the handling and changing of diapers by staff contribute to the spread of HAV infection in day care centers. When administered within 2 weeks after exposure to HAV (0.02 mL/kg IM), IG is 80% to 90% effective in preventing HAV infection.1 IG is more efficacious when administered early in the incubation period; when administered later in the incubation period, IG may only attenuate the clinical expression of HAV infection. The hepatitis A vaccine may be administered at the same time as IG for unvaccinated children and staff members receiving postexposure prophylaxis in day care centers. Ribavirin is used in the treatment of HCV infection, not HAV infection.

    1. Centers for Disease Control and Prevention. Prevention of hepatitis A through active or passive immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2006;55:1-23.

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