Pediatrics

Post exposure prophylaxis

What is post-exposure prophylaxis?

In general, the administration of medication after contact with a harmful pathogen is referred to as post-exposure prophylaxis. The purpose of the medication is to protect the body from the potential disease that could arise in the body as a result of the pathogen that has entered.

Furthermore, protective vaccinations, e.g. in the case of rabies or the administration of so-called immunoglobulins, are also understood as post-exposure prophylaxis.

Serious illnesses can occur when infected with a harmful pathogen. In order to prevent this, post-explosion prophylaxis should be considered immediately. What other emergency medication are available? You can get an overview of these at: What emergency medication are there?

Causes of post-exposure prophylaxis

There are a number of diseases that can cause the use of post-exposure prophylaxis.

One of the best-known pathogens is the HI virus. In the context of a needlestick injury or sexual intercourse with an HIV-infected person, there is a potential risk of transmission that requires the use of post-exposure prophylaxis.

Furthermore, a possible risk of infection with hepatitis B can serve as a reason for post-exposure prophylaxis. Hepatitis B can result, for example, from a needlestick injury that has previously come into contact with the blood of someone with hepatitis B. Hepatitis B is also transmitted through sexual intercourse.

Another possible disease that requires prophylaxis is tetanus, also known as tetanus. People who have no or an outdated vaccination status should be re-vaccinated or treated with immunoglobulins as soon as possible to prevent the outbreak of the disease.

Rabies is also one of the diseases that require post-exposure prophylaxis. If a wild animal or dog with an unknown vaccination status or signs of rabies infection is bitten, this should be initiated immediately.

Post-exposure prophylaxis should also be recommended to those affected if they come into contact with a person who shows signs of meningitis. Meningococcal meningitis is a life-threatening infection with bacteria known as meningococci. In the event of contact with infected people, an outbreak of infection can, in the best case, be countered with prophylaxis.

The diseases listed with further important information can be found at:

The most important thing about HIV
What is hepatitis B?
How dangerous is tetanus actually?
Rabies - that's behind it
What is meningitis?

Post-exposure prophylaxis after a needlestick injury

Needlestick injuries occur primarily in the health care sector. A prick with a needle that was previously in contact with infected material or blood can transmit the pathogen present. The focus is particularly on the HI virus, hepatitis B and hepatitis C.

Post-exposure prophylaxis may be required after a needlestick injury. It depends on several factors.

On the one hand, the so-called index patient is considered, i.e. the person whose blood or fluid was handled.

The blood of the person who sustained a needlestick injury will also be examined.

In addition, the vaccination status of hepatitis B is checked for those affected.

Depending on the results of the blood tests in the index patient and the “needle stick injured”, post-exposure prophylaxis is recommended. Those affected should always present themselves to the doctor so that he can initiate the necessary blood tests and, depending on the findings, decide on further measures.

Post-exposure prophylaxis in HIV

The HIV virus can be transmitted in different ways.These include, above all, unprotected sexual intercourse with an HIV-positive person and an injury with a needle that has previously come into contact with HIV-infected blood.

If there is a risk of HIV transmission, it should ideally be countered by administering HIV prophylaxis within the next 24 hours.

Post-exposure prophylaxis is generally not recommended after 72 hours.

The exact procedure is determined by a specialist doctor, e.g. an infectiologist.

Post-exposure prophylaxis for HIV usually consists of 3 preparations, which should usually be taken over a period of 4 weeks or a month.

Are you afraid of having an HIV disease and have the typical symptoms? In this way you can immediately make sure that there is actually an infection. To do this, read the following article: Symptoms of HIV

Post-exposure prophylaxis in hepatitis B

A possible infection with hepatitis B results, for example, from a needle stick injury with blood infected with hepatitis B. Many people are vaccinated against hepatitis B, but if the vaccination status is inadequate or not available, post-exposure prophylaxis is necessary to reduce the risk of the onset of the disease.

Vaccination and simultaneous administration of immunoglobulins are recommended for post-exposure prophylaxis in unvaccinated persons.

In the case of those who have already been vaccinated, the antibody status in the blood is checked and, on the basis of this, the further procedure or the need for post-exposure prophylaxis is determined.

A vaccination can also be used to prevent a hepatitis B infection in advance. All important information on this topic can be found at: Vaccination against hepatitis B

Post-exposure prophylaxis in hepatitis C.

In contrast to the hepatitis B virus, there is no exposure prophylaxis with the hepatitis C virus. As a countermeasure or to treat a fresh hepatitis C infection, interferon therapy can be initiated, which, according to the latest studies, promises good chances of recovery.

A hepatitis C infection cannot be prevented, and it is also possible that this infection will become chronic. It is therefore all the more important to deal with the virus in detail. Everything you need to know about the hepatitis C virus can be found in the following article: Hepatitis C - that's behind it

Post-exposure prophylaxis in rabies

In our latitudes, rabies is almost extinct.

In other countries, such as Thailand, there is still a risk of rabies, for example after being bitten by a dog. Depending on whether it is a “real” bite wound or contact with the saliva of an animal, those affected are treated promptly with a vaccination or a combination of vaccination and immunoglobulins.

The attending physician then decides the exact procedure on the basis of the exposure to the pathogen and the likelihood of a rabies infection in the animal.

At this point a look at the main page "Rabies" is very important: Rabies - you should know that

Post-exposure prophylaxis in the event of contact with meningococci

These are bacteria that can cause meningitis, also known as meningitis.

This bacterial meningitis is life-threatening for those affected, which is why immediate antibiotic therapy is required even if meningococcal meningitis is suspected.

So-called antibiotic prophylaxis is required for people who have been in direct contact with the infected or suspected infected person, since meningococcal meningitis is a highly contagious disease that is also acutely life-threatening.

The exposure prophylaxis of potentially endangered persons also takes place with an antibiotic and can be administered within a period of up to 10 days.

Great care must be taken with meningitis. Failure to treat the condition can quickly lead to death. For this reason, it is imperative to be familiar with the disease. You can learn the most important information from the following articles:

Meningitis - What to watch out for
Meningitis in the baby

Post-exposure prophylaxis for tetanus

Tetanus or tetanus is caused by a bacterium that occurs sporadically in the environment. Many people are vaccinated in infancy and have adequate immunity through regular booster vaccinations in adulthood.

In the event of an injury, it is important to check the person's vaccination status for tetanus.

If the vaccination status is inadequate or out of date, those affected are re-vaccinated.

The exact vaccination schedule depends on the one hand on the vaccination status and on the other hand on the appearance of the wound - whether it is “clean” or contaminated with dirt or soil. The doctor in charge will then decide on the exact vaccination procedure.

D.iYou might also be interested in these topics:

What is tetanus anyway?
When is a tetanus vaccination indicated?

Post-exposure prophylaxis in measles

Due to the high vaccination rate, measles is less common in the German population today.

However, people who have no or insufficient vaccination status against measles are advised to use post-exposure prophylaxis if they come into contact with measles. This usually consists of one or more vaccinations.

However, how do you know that you've also contracted measles? In this regard, our article could help you: Symptoms of measles

How quickly must post-exposure prophylaxis be administered?

For the various diseases, there are different periods of time at which post-exposure prophylaxis must take place at the latest.

In the case of the HI virus, it is particularly important that anti-virus medication is administered immediately after exposure. The best chance of successfully escaping the virus lies within two hours of being infected with the pathogen. As a rule, exposure prophylaxis should take place within a time window of 24 hours. Drug therapy can also be started beyond this, but then it is considered less effective.

In the case of hepatitis B, post-exposure prophylaxis in non-vaccinated people, with an unknown vaccination status and in people with a low antibody status should ideally also be administered within 24 hours in order to reduce the risk of transmission.

If tetanus-causing bacteria is suspected, therapy must also be initiated immediately, especially in the case of unvaccinated persons. This usually takes place when the injury is presented to the doctor, i.e. usually within a few hours of the accident.

In the case of meningococcal infection, therapy is often initiated as soon as it is suspected, as this is a potentially life-threatening disease. For people who have been in contact with the infected person, post-exposure prophylaxis can take place up to 10 days after contact with the sick person.

Rabies prophylaxis should take place as soon as possible, especially in the event of a bite. Prophylaxis is particularly important in the case of rabies, as this cannot be treated after the onset of the disease and thus practically always leads to the death of those affected.

If unvaccinated or incompletely vaccinated persons are exposed to the measles virus, post-exposure prophylaxis in the form of vaccinations should be carried out within 3 to 5 days at the latest after contact with infected persons.

You can get an overview of the vaccinations at: Vaccination - a blessing or a curse?

How do I know whether post-exposure prophylaxis has been successful?

The success of exposure prophylaxis depends, among other things, on the start of therapy. Prophylaxis in general does not promise 100% protection against the onset of an illness.

With the HI virus, blood tests are carried out to see whether the HI virus is present. These blood tests usually take place after 2 and 6 weeks and finally after about 6 months. After carrying out prophylaxis, an HIV infection can largely be ruled out after this time if the HIV virus is absent in the blood.

Blood tests will also check for hepatitis B infection. It looks for special antibodies and so-called antigens that speak for the presence of a disease or against the presence of the disease.

In the case of rabies, the absence of rabies-specific symptoms basically speaks for a successfully carried out prophylaxis.

In the case of measles, too, if the post-exposure prophylaxis failed, measles-specific symptoms would appear after approx. 7-14 days.

Meningitis prophylaxis can take place up to 10 days after contact with an infected person. Whether an infection has taken place despite prophylaxis can theoretically be determined by the presence of bacteria in the spinal fluid and the blood. However, this usually only takes place after symptoms typical of meningitis appear, which would usually appear after 2-4 days.