Aa
trying to understand risks with blood exposure
Dear Dr. H & HHH - I am at a point of confusion and panic about risks for blood exposure for both HIV and hepatitis. I don’t know if I need testing or counseling. I drove a friend (heterosexual male) home after they underwent some outpatient surgery. My friend was given fluids through an i.v. in the wrist post-surgery. After the nurse helped him into the car, I noticed that the i.v. site was bleeding out onto the hand. The i.v. site had been covered with gauze, but there was still blood. I made sure not to touch the hand, but I’m concerned about the risks if some of the blood got onto surfaces in the car, or I somehow transferred it to my eyes or nose after touching some part of the vehicle. I know HIV is known to die quickly in air; I have less understanding of hepatitis and understand that’s not considered an STD and outside the forum’s scope but if you can comment on that at all I would be so appreciative, as the hep forum seems inactive.
I was an analyst/technical writer in the biotech and drug development fields for several years, and dealt with many topics related to infectious disease treatment. In tandem with this, most of my friends are in medical school and interact with patients with HIV and hep C somewhat regularly. I therefore hear a lot of things I probably shouldn’t hear out of context that have added to my current anxiety and confusion. The person I mention in my question is a dear friend who described an incident a few months ago where they were administering a facial/cosmetic injection to an HIV patient and got some fluid on his shirt (but not in the eyes since they were wearing a mask, protective gear). He was not concerned; obviously I was more alarmed than he was. I personally have no medical or scientific training, but all this information I have dealt with has only served to alarm me further about the potential for exposure via blood-skin contact. I just want to know if I can get back to normal. Thanks so much for what you do.
I was an analyst/technical writer in the biotech and drug development fields for several years, and dealt with many topics related to infectious disease treatment. In tandem with this, most of my friends are in medical school and interact with patients with HIV and hep C somewhat regularly. I therefore hear a lot of things I probably shouldn’t hear out of context that have added to my current anxiety and confusion. The person I mention in my question is a dear friend who described an incident a few months ago where they were administering a facial/cosmetic injection to an HIV patient and got some fluid on his shirt (but not in the eyes since they were wearing a mask, protective gear). He was not concerned; obviously I was more alarmed than he was. I personally have no medical or scientific training, but all this information I have dealt with has only served to alarm me further about the potential for exposure via blood-skin contact. I just want to know if I can get back to normal. Thanks so much for what you do.
MEDICAL PROFESSIONAL
HIV doesn't cause nasal congestion or postnasal drip, and it almost always causes fever. You caught a cold, no more.
That will be all for this thread. Read my reply above carefully, pay attention to it, accept the reassurance, and move on.
That will be all for this thread. Read my reply above carefully, pay attention to it, accept the reassurance, and move on.
Dr. Handsfield - After your last response, I heeded your advice and scheduled an appointment for counseling and was on my way. But the day after that (9/15; exactly 2 weeks after the incident in question), I came down with what I'd normally describe as a cold (sore throat, congestion, postnasal drip, no fever). I assumed that the overwhelming stress and lack of sleep thinking about this stuff finally got me run down. It lasted about 3 days and the congestion moved into my chest for another 4 (I have always been prone to bronchitis). I took my temperature several times a day through all this and it was always about 97.5-98.3. No rash; couldn't find lymph node swelling. All I want to do is check if there is any change in what you recommend with regard to no need for testing based on this? From what I can gather there isn't, but I just don't know anymore. I am not one to be overtested (I have it done once a year w/my physical - always negative) - I just want to doublecheck for this case. thank you again.
MEDICAL PROFESSIONAL
The painful cuticle makes no difference. Your understanding is correct -- testing is not necessary.
Thanks so much for fielding my question Doc. I promise I won't take up much more of your time. Of course in my nervousness about the matter I omitted that I had a painful cuticle or two on my hands during the events described, but from what I see in forum archives, those do not qualify as non-intact skin. Forgive me - I had assumed quite the opposite all along. So my understanding is that no testing would be recommended for this event described.
MEDICAL PROFESSIONAL
Welcome to the forum. You had a somewhat similar question a year ago on the STD forum, about hepatitis C.
The events you describe carried no measurable risk of HIV, hepatitis B, or hepatitis C from casual contact of blood with intact skin. Bloodborne transmission of these infections requires that infected blood get into the blood stream or under the skin. Your friend's attitude toward a potential exposure to a patient's blood is in fact the more proper one. Health care providers don't catch bloodborne viruses by just getting blood on clothing or intact skin. It just doesn't happen.
As for when you "can get back to normal", that's up to you, not me. Based both on this question and the one last year, you seem to understand that your fears of contamination in this and similar settings are not entirely rational. It would be great if you could achieve an emotional as well as intellectual understanding that there is no risk from events like you describe here or last August. But I doubt that will happen. Deep seated anxieties typically are not resolved by reasoned analysis or intellectual understanding. You need to decide if and when these concerns are sufficiently impacting your life that you need professional counseling. Think about it.
Regards-- HHH, MD
The events you describe carried no measurable risk of HIV, hepatitis B, or hepatitis C from casual contact of blood with intact skin. Bloodborne transmission of these infections requires that infected blood get into the blood stream or under the skin. Your friend's attitude toward a potential exposure to a patient's blood is in fact the more proper one. Health care providers don't catch bloodborne viruses by just getting blood on clothing or intact skin. It just doesn't happen.
As for when you "can get back to normal", that's up to you, not me. Based both on this question and the one last year, you seem to understand that your fears of contamination in this and similar settings are not entirely rational. It would be great if you could achieve an emotional as well as intellectual understanding that there is no risk from events like you describe here or last August. But I doubt that will happen. Deep seated anxieties typically are not resolved by reasoned analysis or intellectual understanding. You need to decide if and when these concerns are sufficiently impacting your life that you need professional counseling. Think about it.
Regards-- HHH, MD
You are reading content posted in the HIV - Prevention Forum
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
Can I get HIV from surfaces, like toilet seats?
Can you get HIV from casual contact, like hugging?
Frequency of HIV testing depends on your risk.
Post-exposure prophylaxis (PEP) may help prevent HIV infection.
