Exposure Protocols Contents Introduction .................................................................................................................................................. 4 Flowchart – First Aid and Medical Response Protocol for Human Blood and/or Tissues and MDRO Incidents ........................................................................................................................................................ 6 Medical Surveillance for Primary Blood Products ....................................................................................... 8 Human Immunodeficiency Virus (HIV);................................................................................................. 8 Hepatitis B Virus (HBV); ........................................................................................................................ 8 Hepatitis C Virus (BVC); ......................................................................................................................... 8 Treponema pallidum ............................................................................................................................. 8 Human T-Lymphotropic Virus (HTLV); ................................................................................................ 12 Leptospira interrogans; ....................................................................................................................... 12 Creutzfedlt-Jacob agent, Kuru agent .................................................................................................. 12 Medical Surveillance Breast Milk .............................................................................................................. 15 Human Immunodeficiency Virus (HIV);............................................................................................... 15 Human T-Lymphotropic Virus (HTLV); ................................................................................................ 15 Cytomegalovirus (CMV); ..................................................................................................................... 15 Creutzfedlt-Jacob agent, Kuru agent .................................................................................................. 15 Medical Surveillance Inventory Bacteria ................................................................................................... 21 Streptococcus Group A (S. pyogenes); ................................................................................................ 21 Staphylococcus intermedius; ............................................................................................................... 21 Staphylococcus hyicus; ........................................................................................................................ 21 Streptococcus Group B (S. agalactiae) ................................................................................................ 21 Streptococcus Group C (S. zooepidemicus, S. equi, and S. dysgalactiae); ........................................... 24 Streptococcus Group D;....................................................................................................................... 24 Streptococcus pneumoniae; ................................................................................................................ 24 Candida albicans ................................................................................................................................. 24 Listeria monocytogenes; ..................................................................................................................... 29 Nocardia spp.; ..................................................................................................................................... 29 Streptococcus salivarius (S. viridans); ................................................................................................. 29 SEM 20.25.1 Exposure Protocols – Medical Surveillance Page 1 of 92 Revised: January 26, 2017 Pseudomonas aeruginosa ................................................................................................................... 29 Proteus spp.; ........................................................................................................................................ 34 Bacillus cereus; .................................................................................................................................... 34 Citrobacter diversus; ........................................................................................................................... 34 Enterobacter spp. (E. cloacae, E. aerogenes) ...................................................................................... 34 Haemophilus influenzae; ..................................................................................................................... 39 Pasteurella sp.; .................................................................................................................................... 39 Salmonella enterica spp.; .................................................................................................................... 39 Staphylococcus aureus (MRSA, MSSA, VISA, hVISA, VRSA) ................................................................ 39 Bordatella bronchiseptica; .................................................................................................................. 46 Serratia sp.; ......................................................................................................................................... 46 Klebsiella spp.; ..................................................................................................................................... 46 Vancomycin-resistant Enterococci (VRE) ............................................................................................ 46 Medical Surveillance Sewage Bacteria ...................................................................................................... 54 Legionella pneumophila; ..................................................................................................................... 54 Mycobacterium spp.; .......................................................................................................................... 54 Shigella spp.; ....................................................................................................................................... 54 Helicobacter pylori .............................................................................................................................. 54 Escherichia coli (enterotoxigenic); ...................................................................................................... 59 Escherichia coli (uropathogenic); ........................................................................................................ 59 Escherichia coli (entero-hemorrhagic), ............................................................................................... 59 Escherichia coli (septicemia causing) .................................................................................................. 59 Staphylococcus aureus (MRSA, MSSA, VISA, hVISA, VRSA); ................................................................ 62 Salmonella enterica spp.; .................................................................................................................... 62 Aeormonas hydrophilia; ...................................................................................................................... 62 Campylobacter coli. ............................................................................................................................. 62 Clostridium difficile; ............................................................................................................................ 69 Clostridium botulinum; ........................................................................................................................ 69 Yersinia enteracolitica; ........................................................................................................................ 69 Campylobacter jejuni .......................................................................................................................... 69 Clostridium perfringens; ...................................................................................................................... 76 Klebsiella spp.; ..................................................................................................................................... 76 SEM 20.25.1 Exposure Protocols – Medical Surveillance Page 2 of 92 Revised: January 26, 2017 Actineobacter spp. .............................................................................................................................. 76 Medical Surveillance Sewage Viruses ........................................................................................................ 80 Norovirus; ........................................................................................................................................... 80 Adenovirus serotypes 1-5, and 7; ....................................................................................................... 80 Adenovirus serotypes 40 and 41; ....................................................................................................... 80 Hepatitis A Virus .................................................................................................................................