for household and sexual contacts who haven't received two doses of hepatitis A vaccine (or one dose within the past six months), do not have a history of laboratory confirmed hepatitis A and are seen within 14 days of exposure to infection:
healthy persons aged 12 months to 50 years
a single dose of monovalent hepatitis A vaccine should be given
if the patient is at continued risk of infection a second dose of vaccine at 6-12 months after the first dose should be advised
healthy infants <12 months
post exposure prophylaxis is not required
people aged over 50 years
monovalent hepatitis A vaccine + normal immunoglobulin (HNIG)
should receive a second dose at 6-12 months to ensure long term protection
people with chronic liver disease, pre existing chronic hepatitis B or C infection or HIV infection or immunosupression
monovalent hepatitis A vaccine + normal immunoglobulin (HNIG)
should receive a second dose at 6-12 months to ensure long term protection
pregnant or breast feeding women
same as for non pregnant contacts
for household contacts seen 14 days after exposure to infection:
consider HNIG up to 28 days post exposure for people with risk of severe disease (with chronic liver disease or pre existing hepatitis B or C)
two doses of hepatitis A vaccine given 6 months apart should also be considered in these patients to provide long term protection (irrespective of the time since exposure)
if there is more than one contact in the household, offer vaccination for all contacts seen within 8 weeks of onset of symptoms in the index case
household contact who attends nursery or infant school - proper hand washing technique (under supervision) should be followed to reduce the risk of asymptomatic transmission
for wider communities to control outbreaks
monovalent hepatitis A vaccine should be given (with the second dose given at 6-12 months if contacts are at continuing risk)
those who are at risk of severe infection additional HNIG should be offered (1)
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