• Please confirm if this was an accident or deliverate (DSH) immersion:
  • DSH approach
• These patients do not require any specific therapy
• Patients should consult their GP (and let them know of the fall in the docks) if they develop flu-like symptoms in the next 6 weeks
• Previously we have given prophylaxis against Weil's disease (leptospirosis) and Hepatitis A. However the risk of contracting these conditions does not warrant continuing this policy in most cases
• Patients with prolonged immersion and open wounds may be treated with:
  • An antibiotic and hepatitis A normal immunoglobulin
  • The immunoglobulin is kept in the fridge (dose is 250 units for children < 10 years old, 500 units for children over the age of 10 and adults)
  • Continue Doxycycline (100mg q24h) x two weeks and Amoxicillin 250 mgs q8h x 5 days