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· Immune Globulin (IG)
- Produced from pooled human plasma
- 16.5% protein; 95% IgG
- IM use only; Cohn Fraction two
· Intravenous Immune Globulin (IVIG)
- Produced from pooled human plasma
- 3-12% protein; >95% IgG
- IV use; further processing after fractionation
· Specific Immune Globulin
- Produced from specific donors
- Screened plasma or immunized donors
- Immunized animals (Equine)
- Both IG and IVIG
- Monoclonal antibodies
Type:
Indications for TIG Trauma/Wound Prophylaxis:
· < 3 doses of tetanus vaccine
· Serious or dirty wound (puncture wounds, devitalized tissue; soil, saliva, feces contamination)
· AIDS patients with tetanus-prone wounds (regardless of vaccine status)
· Unknown tetanus vaccine status
Dose:
· Single dose of 3,000 u to 6,000 u
· IM injection
· Infiltrate part of dose around the wound
TIG is not indicated for minor, clean wounds; all wounds should be properly cleaned and derided and foreign material removed. Booster toxoid vaccine may be indicated if < 3 previous tetanus toxoid doses or >10 years since last tetanus toxoid (clean, minor wound) or >5 years since last toxoid dose for more serious contaminated wounds.
Type:
· Human Immune Globulin with increased levels of anti-VZV antibody.
Decision to use VZIG
· Likelihood the individual will develop complications if infected with Varicella.
· Probability an exposure will result in a Varicella infection.
· Likelihood the exposed person is susceptible.
Indications after Varicella-Zoster exposure:
· Immunocompromised children without history of chickenpox. Immunocompromised adolescents and adults are likely to be immune, but if susceptible, they should also receive VZIG.
· Susceptible, pregnant women.
· Newborn infants whose mothers have the onset of chickenpox within 5 days before delivery or within 48 hours after delivery.
· Hospitalized premature infants (> 28 wk gestation) whose mothers have no history of chickenpox.
· Hospitalized premature infants (<28 wk gestation or <1,000 g), regardless of maternal history.
· Household: Residing in the same household
· Playmate: Face-to-face- indoor play
· Hospital:
Varicella:
a) in same 2- to 4-bed room, or adjacent beds in large ward,
b) Face-to-face- contact with an infectious staff member or patient, or
c) Visit by a person deemed contagious.
Zoster: Intimate contact (eg, touching or hugging) with a person deemed contagious.
· Newborn infant: Onset of Varicella in the mother 5 days or less before delivery or within 48 h after delivery. VZIG is not indicated if the mother has Zoster.