Health districts serving the Peninsula are advising all primary care physicians that adults diagnosed with
For those 60 and older, vaccination is at the discretion of the treating doctor. Anyone who completed a full course of the vaccine at a prior time does not need a booster.
"The vaccine has been available for close to 20 years," says Dr. William Berg, director of the Hampton Health District who sent out an email blast relaying the recommendation to area physicians on Wednesday. "What's new is that it's being specifically recommended for diabetics."
One of three
The new advisory comes from the advisory committee for immunization practices of the
The Virginia Department of Health has investigated four outbreaks in long-term care facilities in the state in the past three years; all were in the Central Virginia region and all were associated with assisted blood glucose monitoring, according to Diane Woolard, an epidemiologist with the department.
Infection can occur when more than one patient uses a finger stick device designed for single patient use, and from inadequate disinfection and cleaning of blood glucose monitors between patients.
"HBV is highly infectious and can be transmitted by medical equipment that is contaminated with blood that is not visible to the unaided eye," reports the CDC. Berg speculates that the outbreaks occurred when staff either didn't understand the importance of cleaning the equipment or simply wiped it off in order to save time.
The danger to diabetics is not confined to long-term care facilities; the CDC has recorded similar breaches in blood glucose monitoring in hospitals, community health centers, ambulatory surgical centers, private offices, homes and health fairs — in fact, just about anywhere where blood-glucose levels are checked. Accordingly, diabetics are almost twice as likely as the general population to acquire hepatitis B.
The Virginia Department of Health is working hard to educate health workers to the dangers. It has developed a "health-care associated infections" toolkit that includes a section on glucose monitoring. Last year 500 health-care workers attended training around the state. The toolkit will be available on the department's web site, http://www.vdh.state.va.us, by the end of January. "We're challenged to get the information to everyone," says Woolard.
He adds that one of the benefits of the CDC's advisory committee recommending the HBV vaccine is that as it becomes adopted it should eventually become reimbursable and part of health benefit packages.
The recommended three-shot series of the HBV vaccine provides close to 100 percent protection when completed. "If you don't get the full series, you're not as likely to be protected," says Berg.
For full protection, a series of three shots is recommended with a minimum interval of a month between the first and second shots and five months between the second and third; there is no maximum interval between the shots.