Blood Borne Pathogens

Blood Borne Pathogens What are Blood borne Pathogens? Microorganisms such as viruses, bacteria, or parasites which can enter the human blood stream causing diseases. Common examples include Hepatitis B, Hepatitis C, and HIV (human immunodeficiency virus). How do they enter blood stream? These microorganisms may be transmitted when mucous membranes or non-intact skin (cuts, abrasions, burns) come in contact with human blood or body fluids. Other modes of transmission include blood splashes, handling contaminated items, needle sticks, or cuts from contaminated sharps. Hepatitis What is Hepatitis? Hepatitis means inflammation, redness, swelling, and soreness of the liver. A group of viruses known as the Hepatitis viruses cause most cases of Hepatitis worldwide, but Hepatitis can also be caused by toxic substances (notably alcohol, certain medications, some industrial organic solvents, and plants), other infections, and autoimmune diseases. There are several kinds of Hepatitis viruses. Hepatitis A, B, and C are the most common. Hepatitis A Hepatitis A is an acute infectious disease of the liver caused by the Hepatitis A virus (HAV). HAV is usually spread by the fecal-oral route; transmitted person-to-person by ingestion of contaminated food or water or through direct contact with an infectious person. Tens of millions of individuals worldwide are estimated to become infected with HAV each year. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease. Hepatitis A can be prevented by vaccination. Hepatitis B Hepatitis B Virus (HBV) Hepatitis B is a contagious virus which causes inflammation of the liver. How is Hepatitis B spread? HBV is transmitted by sharing needles, razors, and toothbrushes. Body fluids, saliva, and semen which are exchanged during sexual interactions can cause transmission. HBV is also transmitted from mother to infant during her pregnancy. Who is at risk for Hepatitis B? • Intravenous drug users • Sexual contact with partner infected with Hepatitis B • Living with someone with chronic Hepatitis B • Men who have sexual contact with other men • Having oral-anal sexual contact with someone who has Hepatitis B • Traveling to a country with high rates of Hepatitis B • Health care and public safety workers, who have contact with blood or body fluids or blood contaminated products • Hemodialysis patients • Birth of a child to a Hepatitis B infected mother What are the symptoms of Hepatitis B? Most of the people newly infected with Hepatitis B do not show any symptoms. Most common symptoms (if present) include: • Fever • Fatigue

• Jaundice (yellowing of the skin and/or eyes) • Nausea and Vomiting • Abdominal pain • Dark urine • Clay-colored bowel movements • Loss of appetite How long do Hepatitis B symptoms last? Symptoms may begin as early as 60 days or up to 150 days after exposure to HBV. 95% of the adults recover completely from HBV and do not become chronically infected. In contrast, 90% of infants and 35% of children under the age of 5 years will remain chronically (lifelong) ill with HBV. What is the difference between acute and chronic HBV infection? If a person was infected with Hepatitis B for the first time it is called acute Hepatitis. Usually acute (short term) Hepatitis lasts for 6 weeks or less. Chronic (long term) HBV infection occurs in a minority of the adults who were infected with HBV. In contrast, the majority of the infants who are exposed to HBV will have chronic HBV. Chronic infection may last 6 months or more. What happens in chronic HBV infection? 15-25% of the people with chronic HBV develop liver damage, cirrhosis, liver failure, or liver cancer. How is it treated? There are no special treatments for acute Hepatitis B infection. Patients are told to rest, avoid alcohol, and eat a healthy diet. For chronic infection, many antiviral drugs are available. How can you prevent Hepatitis B? • Avoid sharing of needles, toothbrushes, and razors. • Protected sex (use of condom) • Universal protection for health care and public safety workers • Vaccines are also available for prevention of Hepatitis B infection Who should get vaccinated against Hepatitis B? • All children at birth • Those traveling to countries with high rates of Hepatitis B • Sexual partners of people infected Hepatitis B virus • Men who have sexual contact with other men • Persons who uses injection or non-injection illegal drugs • Persons with end-stage kidney disease. • Health care and public safety workers • People with chronic liver disease • People who are being treated with clotting-factor concentrates Hepatitis C How is it transmitted? Hepatitis C is transmitted by needle stick injury, blood, blood products, sharing needles, razors, toothbrushes, sexual contact with Hepatitis C infected person, and birth to an infected Hepatitis C mother. What is the risk of acquiring Hepatitis C after a needle stick contaminated with Hepatitis C blood? HCV infection is about 1.8%. What are the signs and symptoms of HCV? Most of the people newly infected with Hepatitis C do not show any symptoms. Most common symptoms (if present) include:

• Fever • Fatigue • Jaundice (yellowing of the skin and/or eyes) • Nausea and Vomiting • Abdominal pain • Dark urine • Clay-colored bowel movements • Loss of appetite What is the difference between acute and chronic Hepatitis C? If a person was infected with Hepatitis C for the first time it is called acute Hepatitis. Usually acute Hepatitis lasts for 6wks or less. Approximately 15-25% of patients infected will clear the infection without treatment. What happens to chronic Hepatitis C patients? A majority (70-85%) of the infected people will develop chronic infection. 60-70% of them will have chronic liver disease. 5-20% of patients would develop chronic liver disease. 1-5% will die because of the complications of Hepatitis C. Is there Hepatitis C vaccination? There is no vaccine for Hepatitis C. How to prevent Hepatitis C • Avoid sharing needles, toothbrushes, and razors • Protected sex (use of condom) • Universal protection for health care and public safety workers HIV/AIDS What is Human Immunodeficiency virus (HIV)? Human Immunodeficiency Virus (HIV) is the virus that causes AIDS. What is AIDS? AIDS stands for Acquired ImmunoDeficiency Syndrome. HIV infection causes suppression of the immune system (the immune system gives our bodies the ability to fight infections), which could lead to opportunistic infections and unusual types of cancer. AIDS may not develop for 8-10 years after the initial infection. AIDS is the final stage of HIV infection. How is HIV spread? HIV is transmitted by having sex (anal, vaginal, or oral), blood (sharing needles and syringes), and blood products/body fluids (semen, saliva, etc.) of an HIV infected person. It is also transmitted from HIV infected mother to infant during her pregnancy or breast feeding. Who is at risk for HIV? • Drug or steroid users who share needles and syringes • Unprotected sex (heterosexual and homosexual) • Blood transfusion or clotting factor from 1978 – 1985 • Health care workers who got stuck with needles containing HIV-infected blood or, less frequently after infected blood gets into an open cut or mucous membrane of the eyes or nose What are the symptoms of HIV? Most of the people newly infected with HIV do not show any symptoms for many years. Some people may get flu like symptoms for few weeks after becoming infected. Signs and symptoms may include: • Fever • Headache • Sore throat

• Swollen lymph glands • Rash What are the symptoms of AIDS? AIDS may develop over an 8-10 year period after the initial HIV infection. AIDS is the final stage of HIV infection, when the immune system has been severely damaged, which can lead to opportunistic infections and unusual type of cancers. Signs and symptoms may include: · Night sweats · Chills and fatigue · Fever >100 F (38 C) for several weeks · Dry cough and shortness of breath · Chronic diarrhea · Persistent white spots or unusual lesions on your tongue or in your mouth. · Headaches · Weight loss How long does the HIV infection lasts? There is no cure for HIV infection. Usually HIV infection is a chronic condition. How is it treated? It is treated with a combination of antiviral medications. Treated patients with high CD4 counts and low viral load counts can still transmit HIV and must consider lifestyle changes. What is the risk of HIV infection to a health care worker? The average risk for HIV infection from all types of reported percutaneous exposure (needle stick) with HIV infected blood is 0.3%. How can HIV be prevented? · Avoid sharing of needles, toothbrushes, of an infected HIV person · Protected sex (use of condom) · Universal protection for health care and public safety workers Prevention of Blood Borne Diseases The Occupational Safety and Health Administration (OSHA) defined strategies to prevent or reduce exposure to blood borne pathogens in the work place Engineering controls refers to any object that comes between you and the potential infectious material. Examples are readily accessible hand washing facilities, eye stations, sharps containers, biohazard labels, self-sheathing needles, or syringes with retractable needles, needleless IV systems. Contaminated Sharps ex: Needles, scalpels, broken capillary tubes, dental wires. Contaminated needles or other contaminated sharps must not be bent or recapped. Needle removal or recapping needles must be accomplished through a one-handed technique or the use of a mechanical device. A sharps container must have a warning label affixed to it. Contaminated sharps must be discarded immediately or as soon as possible into an acceptable sharps container. Reusable Sharps including pointed scissors must be decontaminated before reuse. Containers containing reusable sharps should be clearly labeled. Never put your hand in a sharps container. Sharps containers must be replaced when ½ full. Work Practice Controls must be evaluated and updated on a regular schedule to ensure their effectiveness. Healthcare workers must be properly trained and equipped.

Personal Protective Equipment (PPE) is considered special equipment and/or clothing worn for protection against hazard. PPE prevents blood or OPIMs from passing through to or contacting your clothes, or directly to your body. PPE: • Gloves • Gowns • Aprons • Face shields • Masks • Eye protection • Laboratory coats You must remove all PPE before leaving the work area. Universal Precautions means you should treat all human blood and body fluids as if they contain HIV, HBV, HCV or other blood borne pathogens and wear the appropriate PPE. Exposure control Plan Each employer should have an exposure control plan describing the guidelines for employees to follow when an exposure occurs. Most exposure control plans include      

HIV testing and counseling Post-exposure prophylaxis (PEP) is short-term antiretroviral treatment to reduce the likelihood of HIV infection after potential exposure, either occupationally or through sexual intercourse. A test for HIV periodically for at least 6 months Practice “safe” sex Stop breastfeeding Get immediate evaluation of any illness

Information from American Academy of CPR and First Aid, Inc. Retrieved from http://www.onlinecprcertification.net/free_course.php?id=4&page=1&cid=95&type=ch