management of household and sexual contacts

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Management of household and sexual contacts

  • 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)

Reference:

Last reviewed 01/2018