Enclosure (2) to COMDTINST 6220.9A
minimize the likelihood of exposure to hepatitis A. All Coast Guard active duty and selected reserve
personnel are required to be immunized against Hepatitis A.
5. Hepatitis B. Hepatitis B is spread by direct contact with blood or body fluids of an infected person.
Standard precautions (as outlined in the bloodborne pathogen section) should be used for protection
against hepatitis B. All Coast Guard active duty and selected reserve personnel are required to be
immunized against Hepatitis B.
6. Post-Exposure Vaccinations. Post-exposure vaccinations may be needed for Coast Guard personnel
who may not have been adequately immunized, or who have a questionable immunization status and
may have been exposed to an infected individual during boardings, inspections or AMIO. These
situations warrant a report (documented e-mail or telephone call) to the on-duty Flight Surgeon
and/or the Senior Medical Officer of the supporting Coast Guard health clinic to advise on the
requirement. Details of the exposure shall be documented by the unit CO/OIC as a mishap.
C. Tuberculosis.
1. Overview. Tuberculosis (TB) is a communicable disease; however it is relatively difficult to
become infected because close and prolonged exposure to persons with active disease is necessary.
Detailed guidance on TB prevention and control is outlined in reference (d). An effective TB
control program includes:
a) Administrative Controls;
b) Environmental Controls; and
c) Respiratory Protection Controls.
2. Administrative Controls. Administrative controls are the first and most important level of TB
controls. Administrative controls consist of prevention, screening, and case recognition.
a) Prevention. Recommended actions to decrease TB transmissibility include:
(1) Minimize close contact with persons suspected of having symptoms of TB (e.g., excessive
coughing, coughing up blood);
(2) Conduct interviews, medical screening and other activities requiring close contact with
alien migrants in an open air environment; and
(3) Use respiratory protection in select circumstances (e.g., when close contact is required).
Reference (e) has additional guidance on the proper use of respiratory protection.
b) Screening. A tuberculin skin test (TST) (formerly known as the Purified Protein Derivative
(PPD)) is the primary method used for TB screening. There is no historical increased risk for TB
transmission in boardings, inspections or AMIO. Alien migrants who have latent TB infection
based on a positive TST, but who do not have symptoms of active TB (e.g., excessive coughing
and/or coughing up blood) have a low risk of transmitting TB (even if the alien migrant is from a
TB endemic area). Therefore, Coast Guard personnel engaged in boardings, inspections or
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