1988 Agent Summary Statement for Human Immunodeficiency Virus and Report on Laboratory-Acquired Infection with Human Immunodeficiency Virus [MMWR, Vol 37 No.S-4]

Vol. 37 / No. S-4

MMWR

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10. Medical surveillance programs should be in place in all laboratories that test
specimens, do research, or produce reagents involving HIV. The nature and scope
of a surveillance program will vary according to institutional policy and applicable
local, state, and Federal regulations (9).
11. If a laboratory worker has a parenteral or mucous-membrane exposure to blood,
body fluid, or viral-culture material, the source material should be identified and,
if possible, tested for the presence of virus. If the source material is positive for
HIV antibody, virus, or antigen, or is not available for examination, the worker
should be counseled regarding the risk of infection and should be evaluated
clinically and serologically for evidence of HIV infection. The worker should be
advised to report on and to seek medical evaluation of any acute febrile illness
that occurs within 12 weeks after the exposure (3). Such an illness-particularly
one characterized by fever, rash, or lymphadenopathy-may indicate recent HIV
infection. If seronegative, the worker should be retested 6 weeks after the
exposure and periodically thereafter (e.g., at 12 weeks and 6 months after
exposure). During this follow-up period-especially during the first 6-12 weeks
after exposure, when most infected persons are expected to show serologic
evidence of infection-exposed workers should be counseled to follow Public
Health Service recommendations for preventing transmission of HIV (3,14,25,33).
It is recommended that all institutions establish written policies regarding the
management of laboratory exposure to HIV; such policies should deal with
confidentiality, counseling, and other related issues.
12. Other primary and opportunistic pathogenic agents may be present in the body
fluids and tissues of persons infected with HIV. Laboratory workers should follow
accepted biosafety practices to ensure maximum protection against inadvertent
laboratory exposure to agents that may also be present in clinical specimens
(34-36).
13. Unless otherwise dictated by institutional policy, the laboratory director (or
designated laboratory supervisor) is responsible for carrying out the biosafety
program in the laboratory. In this regard, the laboratory director or designated
supervisor should establish the biosafety level for each component of the work to
be done and should ensure that facilities and equipment are adequate and in
good working order, that appropriate initial and periodic training is provided to
the laboratory staff, and that recommended practices and procedures are strictly,
followed (9).
14. Attention is directed to a "Joint Advisory Notice" of the Departments of Labor
and Health and Human Services (9) that describes the responsibility of employers to provide "safe and healthful working conditions" to protect employees
against occupational infection with HIV. The notice defines three exposure
categories of generic job-related tasks and describes the protective measures
required for employees involved in each exposure category. These measures are:
administrative measures, training and education programs for employees, engineering controls, work practices, medical and health-care practices, and recordkeeping. The recommendations in this report are consistent with the "Joint
Advisory Notice"; managers/directors of all biomedical laboratories are urged to
read this notice.