FISH VACCINATORS

If you receive an injection injury while using fish bacterins, see a doctor at once. We cannot legally recommend human medical treatment to physicians. This document serves only as an informational aid to physicians.

Injection Injuries To The Hand

The Injection of foreign material into the fingers or palm is a potentially serious injury. Vaccines, utilized to immunize fish, consist of inactivated bacteria in an oil emulsion (including mineral oil) carrier, This can be accidentally injected into the fingers if proper care is not taken while performing the injection.

After entry of the emulsion into the hand, the emulsion can remain in a small area or distribute itself along the tendon sheath and neurovascular bundles far from the injection site. There is some direct injury to tissue at the time of injection but within 24 hours, there is usually an inflammatory response resulting in significant swelling and increasing pain. Subsequent problems may occur with the possible onset of secondary bacterial infection and late formation of swelling resulting form chronic inflammation because of the body's response to oil emulsion. Late problems consisting of continuing pain and stiffness of the involved part can be expected. One would not expect the inactivated bacteria involved to be a problem by themselves as they do not produce disease in humans and further there are no living organisms present.

If an accident does occur, it is recommended that the victim be immediately referred to a surgeon experienced in the care of hand injuries. They should not be handled in an office setting by someone unfamiliar with this problem. Time is extremely important - Do not delay treatment. Although there is some disagreement among hand surgeons about treatment, the following is an outline of the usual course taken.

1. Special soft tissue x-rays can help to ascertain the extent of distribution of the oil material in the finger or hand. It little or no oil was actually injected, the inflammation may subside spontaneously over several weeks, or with the use of anti-inflammatory drugs, even if the needle penetrated deeply into the hand. If history (no previous injury of a similar nature) and radiograms dictate a conservative approach, a period of close careful observation and functional evaluation should be carried out.
2. If oil emulsion vaccine was actually injected, an extensive debridement (opening the affected part and removing as much of the foreign material as possible) should be carried out. The wound is generally left open and closed later.
3. Broad spectrum antibiotics may be given for as long as two weeks depending on the clinical picture.
4. The use of an anti-inflammatory drug should be considered.