Long term immunity for Hepatitis B is not ensured unless a 3 dose series AND post series positive titer is confirmed.
Testing someone for Hep B c Ab would be positive if someone has had Hepatitis B disease, but not if they completed the vaccine series.
Re: a moment in time Hep B s Ab positive titer interpretation without knowledge of prior vaccine receipt would be difficult to interpret and would not be a
reliable indication of immunity. I refer you to Immunization of Health Care Personnel:
https://www.cdc.gov/mmwr/pdf/rr/rr6007.pdf
MMWR / November 25,
2011 / Vol. 60 / No. 7 1 Immunization of Health-Care Personnel
Recommendations of the Advisory Committee on
Immunization Practices
Maria
Maria C. Lanzi, MS, MPH, ANP-BC, COHN-S, CTH
Nurse Practitioner/Program Coordinator
Employee Occupational Health
Corporal Michael J Crescenz Veterans Affairs Medical Center
3900Woodland Avenue
Philadelphia, PA 19104
Work: 215 823 5800 x 2592
Fax: 215 823 5968
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Tim Crump
Sent: Monday, November 13, 2017 12:43 PM
To: MCOH/EH
Subject: [EXTERNAL] Re: [MCOH-EH] #ExtMail# Re: BBP exposures
I would be interested in knowing how people are testing workers who have not completed the Hepatitis B immunization series. Our staff who sustain a needle
stick or other BBFE afterhours are seen in the ED, where they do not necessarily know their immunization status. They test everyone w/ HepB sAb. My understanding of CDC recommendations is that workers who have not completed the series should be tested w/
HepB core Ab, and that surface antibody is uninterpretable if the immu series is not complete. So my question is, can the HepB surface antibody be used as a marker of immunity to Hep B at that moment, or is it misleading and should be put aside when the immu
series is incomplete, potentially making a worker a candidate for HBIG? Thanks for any insight, Tim
Tim Crump, MSN, FNP
Tim Crump, MSN, FNP
Family Nurse Practitioner
Multnomah Pavilion 1 SE, Suite 1110
Occupational Health
Healthcare Human Resources
Oregon Health & Science University
3181 SW Sam Jackson Park Rd
Mail code: UHN 89
Portland, OR 97239-3098
Department Phone: 503-494-5271
Office Phone: 503-346-1152
Fax: 503-494-4457
Email: crumpt@ohsu.edu
Tues, Thurs, Fri, 8-4:30
The information contained in this EMAIL message is confidential and protected by law. The information is intended only for the person or business identified
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From: MCOH-EH [mailto:mcoh-eh-bounces+crumpt=ohsu.edu@mylist.net]
On Behalf Of Tara Dockery
Sent: Monday, November 13, 2017 8:24 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] #ExtMail# Re: BBP exposures
My facility, through encouragement by our epidemiologist, has freed this response from Employee Health and more turned it into an Emergency Room protocol,
they follow the reccommendations and guidelines, whether its an employee or the public that has been exposed. Follow up and information would be coordinated through them.
Tara Lee Dockery, IP, MT(ASCP), BS
Infection Prevention and Employee Health
Ocean Beach Hospital and Clinics
174 First Avenue North
Ilwaco, Washington 98624
tdockery@oceanbeachhospital.com
Office Phone 360 – 642 - 6307
Cell Phone 509-760-7397
Fax 360-642-6309
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Timothy Herrick
Sent: Monday, November 13, 2017 8:16 AM
To: 'MCOH/EH' <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] #ExtMail# Re: BBP exposures
A question for Kathy Dayvault; for your pep for travelers; how does this work? Are you giving meds for travelers to take with them on their trips abroad?
Or does traveler mean something different in this context?
Tim Herrick
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Fair, Susan
Sent: Monday, November 13, 2017 6:20 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] #ExtMail# Re: BBP exposures
Our in-house pharmacy makes us a packet for three days, however, when I then prescribed only #14 with one refill (if they are tolerating it), the chain pharmacies
have all refused to fill rx unless it is for quantity 34.
Susan Fair, MPAS, PA-C
Yale New Haven Health
Occupational Medicine
New Haven, CT
From: MCOH-EH [mailto:mcoh-eh-bounces+susan.fair=ynhh.org@mylist.net]
On Behalf Of Grubbs, Scott
Sent: Friday, November 10, 2017 6:07 PM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] #ExtMail# Re: BBP exposures
Re Kathy Dayvault’s comments:
I am curious which meds you are using for HIV PEP. We have been told that a three day supply of Truvada was not available, since once the 30 day bottle was
opened the pills had to be used fairly quickly. So, we have been writing for 30 day supplies even if just for a few days. Have your local pharmacies figured a way around that?
Thanks!
Scott Grubbs, MD
WorkWell Occupational Health
Greenville, SC
From: MCOH-EH [mailto:mcoh-eh-bounces+scott_grubbs=bshsi.org@mylist.net]
On Behalf Of Kathy.Dayvault@dekalbmedical.org
Sent: Thursday, October 12, 2017 10:45 AM
To: MCOH/EH
Cc: MCOH-EH
Subject: #ExtMail# Re: [MCOH-EH] BBP exposures
We provide initial care for BBF exposures for students and travelers - meaning we draw initial blood and would give three days of meds if indicated by a positive HIV source.
Follow up care, including continued blood draws and medications is under the direction of their WC or school liability insurance.
The involved person is directed to their WC provider/school for further direction.
For students, this is outlined in our contract with their school/college.
Thanks,
Kathy Dayvault, RN, BSN, MPH
Manager, Occupational Health and Safety
WorksWell Onsite
Dekalb Medical 2701 North Decatur Road
Decatur, GA 30033
ph: 404.501.4972 Fax:404-501-2045
kathy.dayvault@dekalbmedical.org
From: "Morelli, Karen J" <kmorelli@emhs.org>
To: "'mcoh-eh@mylist.net'" <mcoh-eh@mylist.net>,
Date: 10/12/2017 09:18 AM
Subject: [MCOH-EH] BBP exposures
Sent by: "MCOH-EH" <mcoh-eh-bounces@mylist.net>
I am wondering how other clinics bill for blood borne pathogen exposures. Our company caters to member organization hospitals/practices as well as many outside our system clients. Historically,
we have billed the member organization for our services. We would like to move to billing worker’s comp. Getting the worker’s comp information on our members organizations is not an issue, however, we see many locums, travelers, etc. that would be covered
by other worker’s comp carriers. How do you go about gathering this information? Do your facilities charge worker’s comp for BBP exposures?
Thank you for any guidance you may offer!
Karen
Karen Morelli RN, BSN, Clinical Manager
WorkHealth LLC
973-7382
kmorelli@emhs.org
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