13. Exposure to Family Members: Infections and Recent Live Vaccinations

  1. Bipin N Savani MD
  1. Brian G Engelhardt1 and
  2. James E Crowe Jr2

Published Online: 6 SEP 2013

DOI: 10.1002/9781118473306.ch13

Blood and Marrow Transplantation Long-Term Management: Prevention and Complications

Blood and Marrow Transplantation Long-Term Management: Prevention and Complications

How to Cite

Engelhardt, B. G. and Crowe, J. E. (2013) Exposure to Family Members: Infections and Recent Live Vaccinations, in Blood and Marrow Transplantation Long-Term Management: Prevention and Complications (ed B. N. Savani), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118473306.ch13

Editor Information

  1. Professor of Medicine,Director, Long Term Transplant Clinic, Hematology and Stem Cell Transplantation Section, Vanderbilt University Medical Center, Nashville, TN, USA

Author Information

  1. 1

    Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

  2. 2

    Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA

Publication History

  1. Published Online: 6 SEP 2013
  2. Published Print: 1 OCT 2013

ISBN Information

Print ISBN: 9781118473405

Online ISBN: 9781118473306

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Keywords:

  • stem cell transplantation;
  • respiratory viruses;
  • infection control;
  • hand hygiene;
  • vaccines

Summary

Long-term survivors of allogeneic hematopoietic stem cell transplantation (HCT) are at significant risk for infectious complications. Of particular concern are infections with respiratory viruses, which are important causes of morbidity and mortality in this population. Primary prevention of infection includes education, avoidance of sick contacts, and good hygiene practices with an emphasis on thorough hand washing. Vaccination of family members and close household contacts provides an additional opportunity to prevent pathogen transmission. For live attenuated virus vaccines, there is risk that vaccine virus can be transmitted from a vacinee to an immunocompromised individual. Therefore, the inactivated form of a vaccine should be used for close contacts of HCT patients. However, the overall risk for vaccine virus transmission to an HCT recipient is small. Immunization of family members and close household contacts is recommended with common live virus vaccines, including those for measles, mumps, rubella, varicella (Varivax), and rotavirus, since the relatively small risk of transmission is preferable to the risk of severe disease following natural exposure of an HCT recipient to a virulent wild-type pathogen.