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Conventional wisdom suggests that the best way to prevent illness is by minimizing exposure or immunizing prior to a potential exposure. Not all illnesses have vaccines that prevent them, and sometimes exposure can’t be minimized. For some conditions there is a second front of treatment called post-exposure prophylaxis or PEP. Treatments falling into this category may be given after exposure has occurred but before illness has resulted. The hope is to prevent the illness, post-exposure, with treatment.
There are different types of post-exposure prophylaxis, and one kind may be familiar to many people. Those who have ever received an open wound and had a tetanus shot, as part of treatment, have experienced PEP. Another example of this was particularly relevant in 2009, when people were given H1N1 vaccinations after being directly in contact with someone who was ill with the disease, significantly reducing number of cases. Sometimes people who haven’t received other kinds of flu shots get one when they are aware they’ve come into contact with someone with the flu.
Probably one of the most significant post-exposure prophylaxis types was developed in response to the potential for direct contact with the fluids of someone with HIV. This might be as a result of unprotected sex or through needle sticks in the medical setting. There now is post-exposure prophylaxis protocol in place including the use of antiviral drugs for several months. This may very often prevent contraction of HIV, though it does not always work.
Additional diseases that might suggest using post-exposure prophylaxis include Hepatitis B. This has become less common as Hepatitis B vaccines are now part of the regular vaccine schedule for children. PEP would still be recommended for people with autoimmune conditions or who did not receive the shots as children.
PEP has also been extremely useful in the treatment of exposure to rabies. Almost all people who know or suspect they have received exposure have a total of five rabies shots that virtually always prevent the disease, if given within a certain time window. These shots have fortunately improved. People may recall nightmare stories of shots that were given in the stomach, and that hurt very badly. Today’s shots are given into the muscles in the shoulder, and though still uncomfortable, they prevent death from a devastating disease.
Another form of PEP, which may exact greater controversy, does not prevent disease. Instead it may prevent conception. The morning after pill is after the fact birth control, that when taken shortly after sexual intercourse, can reduce pregnancy changes. It is not an abortifacient, and is not likely to result in death of an egg that is already implanted. An additional method that was and still is practiced to some degree is performing a D&C, usually right after a woman has been raped.