Exposure to measles, hepatitis A, and polio viruses

Product for post-exposure treatment: human normal immunoglobulin (HNIG)

Risk assessment

• Contact Wessex PHE health protection team:
  
  • Tel 0845 055 2022
  • Out of hours on-call service 0844 967 0082.
• For in-patients phone the department of infection
  • Ext. 5101 or 6408.

• Out of hours ask for the microbiologist on call by phoning switchboard on 023 8077 7222.

Please note that HNIG is administered by the intramuscular route. However, the route of injection is different (subcutaneous) in case of bleeding disorders.

Human normal immunoglobulin (HNIG) prescription form

Prescription for HNIG: must be signed by clinician with responsibility for the patient. HNIG stock and issuing centre: UHS pharmacy. Please note: HNIG is issued only when UHS Pharmacy receives the prescription form. Deliver or fax (023 8120 6792) prescription form to the main dispensary at Southampton General Hospital. If faxed, the original prescription will need to be received by pharmacy within 72 hours. Out-of-hours, contact on-call pharmacist through switchboard (023 8077 7222).

General information about measles, hepatitis A and polio

Measles

Measles is a serious respiratory disease caused by measles virus. It spreads easily when an infected person breathes, coughs, or sneezes. It is very contagious and the infection can be acquired by being in a room where a person with measles has been, even after that person is gone.Measles starts with a fever, which can get very high and, soon after, it causes a cough, runny nose, and red eyes (prodromal period). Then a rash develops starting at the head and spreading to the rest of the body. The rash can last for a week, and coughing can last for 10 days. Measles can be transmitted from an infected person before they have measles rash, during the prodromal period.Measles can be dangerous, especially for infants, young children, pregnant women and immunocompromised patients.

Hepatitis A

Hepatitis A virus (HAV) infection causes a range of illness from mild, non-specific nausea and vomiting to hepatitis (liver inflammation, jaundice, or icterus) and rarely liver failure. Symptoms and severity of the illness are worse in older individuals and in those with chronic liver disease.

Hepatitis A virus was a common childhood infection in the UK until a few decades ago. Now, in the 21st century, it is uncommonly acquired in the UK and the majority of individuals diagnosed with acute HAV infection are exposed to the virus abroad. HAV normally spread by the faecal-oral route but can occasionally be spread through blood. Infection is prevented by good hygiene, especially hand washing, safe drinking water and food. Post exposure prophylaxis (passive with Immunoglobulin and active with HAV vaccine), can prevent the disease in susceptible individuals who have been in contact with someone else who has the infection. Travellers to countries where the infection is common should receive hepatitis A vaccine before travelling abroad to highly endemic countries.

Poliomyelitis

Polio is a highly infectious vaccine preventable disease. It invades the nervous system, and can cause total paralysis in a matter of hours. It can strike at any age, but affects mainly children under five. The virus enters the body through the mouth and multiplies in the intestine. Most people infected with the poliovirus have no signs of illness; symptomless people can spread the infection to thousands of others before the first case of polio paralysis emerges. In a minority of individuals poliovirus invades the nervous system, and can cause total paralysis in a matter of hours. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.