Prophylactic Treatment. Due to the hazard of blood borne pathogens and infectious disease exposure to firefighters and EMS personnel who respond to emergency medical and hazardous materials incidents and as a result of the State of Ohio Workers Compensation Plan not allowing a Worker’s Compensation claim for exposure only, the City agrees to pay for diagnostic testing to determine if an infectious disease has been contracted. Further, the City agrees to pay a maximum of $1,500 per employee for those employees who wish to participate in medication treatment for HIV prophylaxis after exposure as provided be medical center. Treatments for HIV exposure shall conform to the current Center for Disease Control (CDC) standards. If an infectious disease has in fact been contracted due to a work related incident exposure, the claim will then be submitted to the Ohio Bureau of Workers Compensation for determination of allowance and subsequent benefits.
Prophylactic Treatment. As recommended in HLH treatment guidelines, patients will receive prophylactic treatment for Pneumocystis jiroveci and fungal infections. In addition, prophylaxis for HZ virus infection will be performed to mitigate the potential risk associated to NI-0501 administration (see Benefit/Risk Management, Section 9.5). In the unlikely event that a patient, previously vaccinated for TB, shows a Purified Protein Derivative (PPD) test result ≥ 5mm and a negative IFNγ-release assay, the patients will receive prophylaxis. Patients will therefore receive prophylactic treatments starting from the day prior to initiation of NI-0501 treatment (i.e. SD-1) until the end of the study: • For Pneumocystis jiroveci prevention, according to Institution Guidelines/ Recommendations (e.g. 750 mg/m2/day sulfamethoxazole with 150 mg/m2/day trimethoprim given orally in equally divided doses twice a day, on 3 consecutive days per week). • For fungal infection prevention, according to Institution Guidelines/Recommendations (e.g. Fluconazole 12 mg/kg daily with a maximum of 400 mg daily dose). • For Varicella Zoster virus prevention, according to Institution Guidelines/Recommendations (e.g. Acyclovir 200 mg four times daily for children over two years, for children under two years 100 mg four times daily).
Prophylactic Treatment. Human rabies fatalities occur because of exposure via an infectious animal and a subsequent lack of treatment [17]. Pre-exposure prophylaxis (PrEP) consists of a series of 3 vaccinations that are administered over the course of a month. PrEP impacts the number of PEP vaccines needed after a potential exposure, and is therefore recommended for healthcare workers or veterinary workers who are likely to come into contact with rabid animals [17, 22]. If an exposure occurs, an individual who received PrEP will need fewer vaccine doses and will not need immunoglobulin [17]. The administration of rabies vaccines can be costly and should always be done with a proper risk assessment [22]. Human vaccination in the form of post-exposure prophylactic treatment (PEP) reduces the number of human rabies cases by preventing the onset of disease [22]. PEP treatment consists of a series of 5 vaccinations over the course of 1 month as well as the administration of immunoglobulin (human antibodies) [17]. PEP administration should always be performed in conjunction with routine animal vaccination to avoid an over-reliance on PEP treatment and to promote sustainability of prevention and control measures [22]. Vaccine quality is a critical issue in PEP treatment. In some developing countries vaccines are manufactured from nerve cells of infected animals. These vaccines are unsafe and their use should be avoided and discontinued [17]. Safe vaccines are obtainable from international manufacturers and can also be produced in country with appropriate modern technology. These vaccines use an inactivated viral strained obtained from cell cultures or avian embryos [17]. Stakeholders should ensure that safe and efficacious vaccines are procured and administered to exposed individuals. This quality standard will prevent disease and build trust in the effectiveness of vaccination among the public. Education and Communications The average rabid dog bites 4-7 people during its infectious stage, which can last up to 10 days [3]. An infection can take up to 60 days to fully develop from the initial exposure [3]. Without proper and timely administration of PEP vaccines, those bitten will die of infection with rabies. Without communication to the public and healthcare workers about the importance of routine animal vaccination, identifying potential exposures to rabies, and proper and timely treatment of animal bites, efforts to reduce or prevent infection among both canine and human populations...
