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GENERAL INFORMATION ON IMMUNISATION
To conform to statutory requirements part of our role is to offer immunisation/and
or screening to protect staff and patients from the potential risk of infectious
diseases. Due to the hazards identified within your workplace/duties an update is
required for you in the areas ticked below.

HEPATITIS B:
Also known HBV or Hep B is a virus which may in some people not cause any
symptoms but may in others cause flu like illness, tiredness, joint pains and loss
of appetite. In more severe cases it causes abdominal pain and jaundice.
Infection may result in illness for a few weeks whilst in others, damage to the liver
may be fatal.
Occupational transmission may be through blood or blood stained body fluids,
where only a small amount of infected blood (0.1ml) may cause infection.
Immunisation is offered for protection of health care workers who have close
contact with patients or body fluids/tissues. Staff who perform exposure prone
procedures (appendix A) have a duty to comply with Scottish Government Health
Department Guidelines and provide *proof of immunity to hepatitis B or proof of
freedom from infection. It is important following. It is important following an
incident of possible contamination that the NHS Highland Policy on Management
of Sharps Injuries, Blood and Body Fluid Exposure in Healthcare is followed
regardless of your Hepatitis B immune status.
The standard course Hep B immunisation is at 0,1 and 6 months. Approximately
10% of vaccinees do not respond to immunisation therefore it is important that
you do not assume you are protected – blood test 2-4 months after completion of
course ascertains a response and the possible duration of protection.
*Certificate/Letter- signed and stamped by Occupational Health or GP or
serological report.

TUBERCULOSIS:
Human tuberculosis (TB) may affect any part of the body with 75% of new cases
in the UK involving the respiratory system. TB is most commonly acquired by
aerosol spread. Symptoms are vague and may include prolonged unexplained
cough, night sweats, fever and weight loss.
Guidelines from the Health Protection Scotland recommend healthcare workers
who have contact with patient or potentially infectious specimens should be
screened for evidence of BCG immunisation and offered a Mantoux Test and
BCG immunisation if necessary. Evidence should also be established of
infectious TB among NHS staff.

RUBELLA:
Is a mild infectious disease which causes a transient rash, swollen glands, and
occasionally in adults –arthritis Clinical diagnosis is unreliable, since other
viruses can cause the symptoms. A history of Rubella should not be accepted
without serological evidence of infection.
Infection in pregnancy may result in foetal damage in up to 90% of infants in the
first 8-10weeks a decline to 10-20% by 16 weeks. All NHS staff in regular contact
with pregnant patients are screened and those non-immune or susceptible
immunised with rubella vaccine.

MEASLES
Measles is an acute viral illness and one of the most highly
communicable infectious diseases. It is spread by airborne or droplet
transmission. There is a prodromal stage characterised by the onset of
fever, malaise, coryza, conjunctivitis and cough, before appearance of an
erythematous and maculopapular rash, starting at the head and spreading
to the trunk and limbs over three to four days. Individuals are infectious
from the beginning of the prodromal period (when the first symptom
appears) to four days after the appearance of the rash. Laboratory
confirmation of suspected cases is required.

HEPATITIS A
Is a viral infection of the liver which is transmitted by the faecal oral route, by
person to person spread or by contaminated food/drink. Severity of symptoms
tends to increase with age and occasional cases of fulminant Hepatitis may
occur. There is no chronic carrier state and little likelihood of chronic liver
damage.

TYPHOID
Fever is a systemic infection caused by salmonelli typhi which may cause gastroenteritis or more severely – prolonged pyrexia and fatigue. It is spread by the
faecal oral route usually through contaminated food/drink.

DIPHTHERIA
Is an acute infectious disease, which affects the upper respiratory tract and
occasionally the skin. An inflammatory discharge forms a greyish membrane in
the respiratory tract, which may cause obstruction. Spread is by droplet infection
and through contact with soiled articles. A toxin produced by diphtheria bacilli
may affect the heart, nervous or adrenal tissues.

INFLUENZA
Is an acute viral infection of the respiratory tract with an incubation period of 1-3
days and lasting 2-7 days if uncomplicated There are two types responsible for
most clinical illness – influenza A & B. Vaccine is prepared each year to target
the strain considered most likely to be circulating in the forthcoming winter.
Immunisation of healthcare workers is not recommended as routine but those
with chronic medical conditions e.g. renal failure, diabetes mellitus, respiratory
disease (asthma), immunosuppression due to disease or treatment, including
asplenia, may be offered annual immunisation.

CHICKENPOX:
(Varicella Zoster Virus) is an acute highly infectious disease that is most
commonly transmitted by personal contact or droplet spread. Vesicles (spots)
appear on the face and scalp and spread to the trunk/limbs. In some people
there may be very few vesicles.
The disease can be more serious and potentially fatal to pregnant women,
neonates and immunosuppressed individuals. There is a risk of congenital
defects – microcephaly, limb hypoplasia and varicella pneumonia.
Staff in regular contact with pregnant patients/ neonates should be screened on
taking up post and others depending on area and risk may be screened post
exposure.
Approximately 95% of the population are immune to chickenpox and therefore
history of infection is considered as evidence of immunity. Those staff with no
personal or close family contact may be screened for immunity. Those staff who
are non-immune, with direct patient contact, are recommended Varicella
vaccine.

TETANUS:
Is an acute infection characterised by muscular spasm/rigidity. It is caused by
toxin of tetanus bacilli which grown at the site of injury. Tetanus spores are found
in soil and may be introduced through a puncture wound burn. Tetanus prone
wounds may include those exposed to soil/manure, extensive tissue injury or
wounds with clinical evidence of infection. Routine immunisation in adults who
have received a total of 5 doses of vaccine is not indicated. The advised interval
between boosters is 10 years.

POLIO:
Virus affects the nervous system and infection may be clinically inapparent or
result in paralysis. Transmission is through contact with faeces or pharyngeal
secretions of an infected person.
Polio vaccine is normally given orally. It is absorbed in the gut and excreted in
the stool for up to 6 weeks, therefore STRICT PERSONAL HYGIENCE IS
IMPORTANT. The incidence of polio in Europe is low and usually related to
vaccination i.e. vaccinee or contact of vaccinee.