Clinical experience of intramuscular immunoglobulin for measles prophylaxis in children: Is it practical?

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Philips, Leanne
Young, Megan K
Wallace, Janet
Dobinson, Hazel C
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2020
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Abstract

Measles continues to be a public health concern world‐wide. Vulnerable individuals including those in which vaccinations is contraindicated, may be reliant on normal human immunoglobulin (NHIG) prophylaxis in an aim to prevent disease. This paper will summarise and discuss a tertiary paediatric hospital's clinical experience and the practicalities of administering intramuscular (IM) NHIG to paediatric patients as per the current measles prophylaxis guidelines in Australia. Following potential exposure within the emergency department, 17 paediatric patients (0–15 years) were recommended IM NHIG for prophylaxis. The dose of NHIG ranged from 0.6 to 15 mL and required multiple (2–8) injections. Two patients required sedation for staff to safely administer the injections. Staff involved with these cases reported administering multiple injections to paediatric patients to be a traumatising experience. They also expressed views that the injection of large volumes via the IM route was an impractical method of administration. Based on this experience, we recommend intravenous immunoglobulin be considered when large volumes of NHIG are recommended intramuscularly.

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Journal of Paediatrics and Child Health

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© 2020 Paediatrics and Child Health Division (Royal Australasian College of Physicians). This is the peer reviewed version of the following article: Clinical experience of intramuscular immunoglobulin for measles prophylaxis in children: Is it practical?, Journal of Paediatrics and Child Health, which has been published in final form at 10.1111/jpc.14800. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)

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Paediatrics

Reproductive medicine

Clinical sciences

Health services and systems

Public health

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Life Sciences & Biomedicine

Pediatrics

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Philips, L; Young, MK; Wallace, J; Dobinson, HC, Clinical experience of intramuscular immunoglobulin for measles prophylaxis in children: Is it practical?, Journal of Paediatrics and Child Health, 2020

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