1. Staff Health Care Infectious Disease view Jameel Adnan, MD. Community & Primary Health Care KAAU- RABEG BRANCH

2. What do you look for? Reduces the risk to health care consumer of acquiring an infection Reduces the risk to health care provider of acquiring an infection

3. What are we at risk of? Hepatitis B and C HIV TB Chicken Pox Measles Influenza Meningococcal disease Hemorrhagic fever

4. Blood-borne pathogens Vaccine preventable Practice preventable Pre-employment evaluation Vaccination Not immunized Immunized but no documented response Immunized with documented response Partially immunized

5. Cont…blood-borne pathogens Post-exposure prophylaxis Status of the exposed Unvaccinated Known responder Known non-responder  Not revaccinated  Revaccinated Unknown antibody response

6. Cont…blood-borne pathogen What about the source HBsAg positive HBsAg negative Unknown source High risk Low risk

7. 1.6 billion are infected with M. tuberculosis 15 million have clinical disease 9 million diagnosis each year 2 million TB related deaths After good decline late in the 70’s and early 80’s; the surge came back late in the 80’s and the early 90’s Pulmonary Tuberculosis

8. Cont…Pulmonary Tuberculosis 25 – 49 case/100,000 population Pre-employment screening (look for risks of exposure) Pre-employment and on-employment measures Follow up

9. Risks for exposure High risk of exposure Close contacts Borne at prevalent area Living in prevalent area Ethnic minority Children of high risks IDU HCW who serve high risks

10. Cont…Pulmonary Tuberculosis Post-exposure prophylaxis Mode of transmission Factors for transmission Proximity Contact time Work restrictions Adequate therapy is being received The cough has resolved Sputum is negative for AFB x3

11. BCG vaccination It is not a primary preventive strategy among HCW Effectiveness Still consider when; High risk of exposure Strong likelihood of transmission of MDR Despite implementation of precaution failure of prevention is recorded Cont…Pulmonary Tuberculosis

12. Chicken Pox Pre-employment screening Post-exposure management

13. Measles Pre-employment screening Post-exposure prophylaxis

14. Respiratory and contact borne pathogens Influenza Meningococcal disease Hemorrhagic fever

15. THANK YOU