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Preventing Contact Transmission

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Unlike other current immunizations, smallpox vaccination is characterized by a virus that propagates in the skin and can potentially contaminate the vaccinee’s hands or the skin and mucosa of others with whom the vaccinee comes into contact.

It is important to prevent dissemination of the vaccinia virus from the vaccination site to other parts of the vaccinee’s body or to others.

General principles for the care of vaccinees and the protection of healthcare system employees and susceptible patients follow.

   Healthcare Systems

   Contact with recent vaccinees can pose a threat to healthcare workers and patients if the vaccine site is not covered as described above and strict hand hygiene is not practiced.

The Advisory Committee for Immunization Practices (ACIP) has recommended that recently vaccinated healthcare workers who follow the appropriate guidelines for vaccine site dressing and hand hygiene do not need to be placed on leave as these precautions greatly minimize the risk to patients or other healthcare workers.

   Treat Contaminated Materials as Infectious Waste

   Great care must be taken to keep all materials that might be contaminated separate from general areas:

•  Towels
•  Gowns
•  Instruments
•  Etc.

These materials should be placed in an appropriate biohazard container and treated as infectious waste.



Advise vaccinees and/or guardians that until the vaccine site has healed (scab has completely separated):

•  Keep the vaccination site covered(*)
•  Do not touch, scratch or rub the vaccination site(†)
•  Make sure the vaccine site is appropriately covered and good hand hygiene practices are followed whenever close physical contact with others is possible (§)
•  Avoid touching, rubbing or otherwise performing any maneuvers that might transfer vaccinia virus to the eye or surrounding skin
•  Discard the vaccination site covering carefully(**)
•  After handling the vaccination site covering, thoroughly wash hands with soap and running water or other hand disinfectant
* Clean or sterile gauze (loosely taped) is recommended. Healthcare workers involved in patient care should use gauze covered by a semi-permeable dressing.
A special problem because the site is usually itchy.
§ Healthcare workers can continue patient care activities as long as the site is covered with the appropriate dressing and strict hand hygiene guidelines are followed.
** The covering contains viable virus and can spread the infection to others. Carefully enclose the gauze in a plastic bag that can be sealed prior to placing it in a trash receptacle.

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